Individual
JODI EILEEN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1190 E MISSOURI AVE STE 100, PHOENIX, AZ 85014-2719
(602) 393-0520
Mailing address
6 N FRASER DR, MESA, AZ 85203-8806
(480) 203-8600
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
353569
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
353569
NATIONAL BOARD OF OCCUPATIONAL THERAPY
AZ
Enumeration date
02/21/2020
Last updated
02/21/2020
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