Individual
AMANDA EILEEN FARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5944 WOODED ESTATES LN, EDWARDSVILLE, IL 62025-5811
(618) 407-1396
(618) 692-0942
Mailing address
PO BOX 387, EDWARDSVILLE, IL 62025-0387
(618) 407-1396
(618) 692-0942
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
57.003783
IL
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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