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Individual

ANDREW F. CALDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11020 STATE ROUTE 250, LAWRENCEVILLE, IL 62439
(618) 943-3754
(618) 943-3657
Mailing address
11020 STATE ROUTE 250, PO BOX 516, LAWRENCEVILLE, IL 62439
(618) 943-3754
(618) 943-3657

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
376006178008
IL
Enumeration date
02/01/2019
Last updated
02/01/2019
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