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Individual

MRS. ELIZABETH PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 353-3343
(812) 353-3346
Mailing address
2605 E CREEKS EDGE DR, BLOOMINGTON, IN 47401-8368
(812) 353-3343
(812) 353-3346

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004111A
IN

Other

Enumeration date
11/09/2009
Last updated
04/10/2018
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