Individual
MARITA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OT/L
Contact information
Practice address
1551 HUNTINGTON DR, CALUMET CITY, IL 60409-5440
(708) 862-5500
Mailing address
1551 HUNTINGTON DR, CALUMET CITY, IL 60409-5440
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008844
IL
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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