Individual
IVY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 N MAIN ST, WESTFIELD, WI 53964-9039
(608) 296-3811
(608) 296-2480
Mailing address
237 STRANGEWAY AVE, LODI, WI 53555-1309
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2412-154
WI
Other
Enumeration date
06/12/2009
Last updated
06/12/2009
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