Individual
MISS JANE LUCILLE B. EDQUILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCCUPATION THERAPY
Contact information
Practice address
1000 114TH ST, WHITING, IN 46394-1048
(219) 659-2770
Mailing address
1404 ROBERTS AVE, APT. 4, WHITING, IN 46394-1166
(773) 679-0689
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004395A
IN
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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