Individual
DEBRA JEAN LOTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1572 N MOUNT ZION RD, JACKSONVILLE, IL 62650-6059
(217) 473-0278
Mailing address
1572 N MOUNT ZION RD, JACKSONVILLE, IL 62650-6059
(217) 473-0278
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
DL38640602P
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007
DEVELOPMENTAL THERAPIST
IL
Enumeration date
05/03/2007
Last updated
07/08/2007
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