Individual
DEBRA LYNN BLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR-L
Contact information
Practice address
510 S STALEY RD STE A, CHAMPAIGN, IL 61822-9234
(217) 493-4175
(217) 351-6486
Mailing address
1 WELSH COBB CIR, WHITE HEATH, IL 61884-9702
(217) 687-4175
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07432001
BLUE CROSS
IL
Enumeration date
12/13/2006
Last updated
07/08/2007
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