Individual
MRS. ANGELA MARIE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 CHURCH ST, XENIA, IL 62899-1241
(618) 678-2596
(618) 662-6462
Mailing address
311 CHURCH ST, XENIA, IL 62899-1241
(618) 678-2596
(618) 662-6462
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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