Individual
ELISABETH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCSP
Contact information
Practice address
120 EASTGATE DR, WASHINGTON, IL 61571-9236
(309) 423-3111
Mailing address
303 OAKBROOK DR, EAST PEORIA, IL 61611-1584
(309) 437-8524
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1006734
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004796
NATIONAL ASSOCIATION OF SCHOOL PSYCHOLOGISTS
IL
01
—
1006734
ILLINOIS STATE BOARD OF EDUCATION
IL
Enumeration date
06/08/2022
Last updated
06/08/2022
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