Individual
JOANNA BROOKE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4680 OLD BROWNLEE RD, BOSSIER CITY, LA 71111
(318) 326-4259
Mailing address
PO BOX 342, QUITMAN, LA 71268-0342
(318) 254-3052
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
324602
LA
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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