Individual
MS. SANDI PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 824-0057
(731) 784-1510
Mailing address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 824-0057
(731) 784-1510
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000000957
TN
Other
Enumeration date
12/12/2007
Last updated
12/12/2007
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