Individual
MS. BEVERLY LOUISE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3020 N VICTORIA AVE, PEORIA, IL 61604-2322
(309) 657-8704
Mailing address
3020 N VICTORIA AVE, PEORIA, IL 61604-2322
(309) 657-8704
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
057'002773
IL
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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