Individual
MS. MARY C EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1168 S MONTCLAIR DR, PUEBLO WEST, CO 81007-2650
(719) 406-6734
Mailing address
1168 S MONTCLAIR DR, PUEBLO WEST, CO 81007-2650
(719) 406-6734
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0000414
CO
Other
Enumeration date
09/10/2012
Last updated
06/08/2014
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