Individual
BLAIRE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4900 HIGHWAY 169 N, NEW HOPE, MN 55428-4058
(612) 877-8800
Mailing address
4900 HIGHWAY 169 N, NEW HOPE, MN 55428-4058
(612) 877-8800
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202261
MN
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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