Individual
KELLY ANN PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA OTR/L
Contact information
Practice address
9346 OAK AVE, WACONIA, MN 55387
(952) 223-2506
(952) 443-2038
Mailing address
9346 OAK AVE, WACONIA, MN 55387-9422
(952) 223-2506
(952) 443-2038
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103086
MN
Other
Enumeration date
07/05/2006
Last updated
01/08/2020
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