Individual
MRS. LISA JANE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 MORTON AVE, RIDLEY PARK, PA 19078-2409
(610) 521-1331
Mailing address
1837 LAUREL AVE, BOOTHWYN, PA 19061-2742
(484) 483-7214
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
4998
NC
224Z00000X
Occupational Therapy Assistant
Primary
OP006627
PA
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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