Individual
MS. ERICA JAYNE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
9492 DEERECO RD, TIMONIUM, MD 21093-2102
(410) 308-7182
Mailing address
3850 BOSTON ST APT 5061, BALTIMORE, MD 21224-5777
(301) 503-3897
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
23713
MA
225100000X
Physical Therapist
Primary
29533
MD
225100000X
Physical Therapist
—
MA
2255A2300X
Athletic Trainer
1554
MD
2255A2300X
Athletic Trainer
2972
MA
Other
Enumeration date
05/11/2016
Last updated
06/19/2024
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