Individual
JAIMIE LYNETTE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
1 RAPP RD, ALBANY, NY 12203-4491
(518) 867-3061
Mailing address
111 BIITTIG RD, AVERILL PARK, NY 12018-3003
(518) 674-0367
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003145-1
NY
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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