Individual
JULIE ANNE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
416 RONDELAY DR, DURHAM, NC 27703-9223
(919) 596-3586
Mailing address
416 RONDELAY DR, DURHAM, NC 27703-9223
(919) 596-3586
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0145
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139CT
BCBS PROVIDER #
NC
Enumeration date
03/19/2007
Last updated
07/08/2007
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