Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | NJ | |
N | 225XH1200X | Occupational Therapist - Hand | OC014094 | PA |
NPI | 1033587019 |
---|---|
Provider Name | Holly M Peters |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2015 |
Last Update Date | 09/09/2015 |