Individual
GARY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1200 HAMILTON BLVD, PEORIA, IL 61606-1525
(309) 637-1696
(309) 589-7981
Mailing address
1200 HAMILTON BLVD, PEORIA, IL 61606-1525
(309) 637-1696
(309) 589-7981
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180003875
IL
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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