Individual
MICHELL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3820 47TH ST, NEW SALEM, ND 58563-9029
(701) 321-1177
Mailing address
3820 47TH ST, NEW SALEM, ND 58563-9029
(701) 321-1177
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1545
ND
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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