Individual
JESSICA L ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
259 W CHESTNUT ST, CANTON, IL 61520-2465
(309) 338-0048
Mailing address
259 W CHESTNUT ST, CANTON, IL 61520-2465
(309) 338-0048
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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