Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 104121 | MN |
NPI | 1003196148 |
---|---|
Provider Name | Chelsey Marie Peters |
First Address | Inver Grove Heights, MN 55076-2018 |
Second Address | Inver Grove Heights, MN 55076-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2011 |
Last Update Date | 08/08/2021 |