Individual
MISS STACIA LYNN EDWARDS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
BS, MOT, OTR/L
Contact information
Practice address
11665 AVENA PL, SUITE 106, SAN DIEGO, CA 92128-2421
(858) 673-5437
(858) 673-5434
Mailing address
18674 CAMINITO CANTILENA, # 237, SAN DIEGO, CA 92128-6127
(619) 252-5762
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 7498
CA
Other
Enumeration date
03/28/2006
Last updated
07/08/2007
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