Individual
MS. MARIAN LYNN EDMUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7300 34TH AVE, MOLINE, IL 61265-5842
(309) 792-5940
Mailing address
407 S OAKWOOD AVE, GENESEO, IL 61254-1567
(309) 507-1714
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
00744
IA
224Z00000X
Occupational Therapy Assistant
Primary
057.002193
IL
Other
Enumeration date
12/02/2008
Last updated
12/02/2008
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