Individual
MS. STORMY CHRISTEN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
19130 SUNNY ACRES RD, PETERSBURG, IL 62675-7306
(217) 632-2334
Mailing address
503 N SPRINGFIELD RD, ATHENS, IL 62613-9477
(217) 632-2334
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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