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General NPI Number Information
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NPI Number | 1821806431
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Entity Type | Individual
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Provider Name | ROSEMARY ELLEN PETERS OTD
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Gender | Female
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Dates
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Enumeration Date | 12/28/2024
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 2385 LAWRENCEVILLE HWY STE A
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City | DECATUR
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State | GA
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Zip | 30033-3168
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Country | US
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Telephone | 404-289-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 5109 BOLD SPRINGS RD
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City | DACULA
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State | GA
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Zip | 30019-2744
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Country | US
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Telephone | 770-267-9357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT009395
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License Number State | GA
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