Individual
MRS. ANITA SUE LIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1017 W FLETCHER ST, VANDALIA, IL 62471-1007
(618) 283-5166
Mailing address
93 E 1125 AVE, MULBERRY GROVE, IL 62262-3509
(618) 292-9613
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005588
IL
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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