Individual
LISA MARIE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L, BSRS
Contact information
Practice address
3057 N PERRYVILLE RD, ROCKFORD, IL 61114-8016
(815) 637-1100
Mailing address
3057 N PERRYVILLE RD, ROCKFORD, IL 61114-8016
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008535
IL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
07/31/2012
Last updated
04/17/2020
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