Individual
LISA MORITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20533 GLENWOOD RD, COAL VALLEY, IL 61240-9280
(309) 314-1885
Mailing address
20533 GLENWOOD RD, COAL VALLEY, IL 61240-9280
(309) 314-1885
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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