Individual
SALONIA M ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
131 BOWMAN ST, MATTESON, IL 60443-3015
(708) 600-7492
Mailing address
131 BOWMAN ST, MATTESON, IL 60443-3015
(708) 600-7492
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004058
IL
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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