Individual
ALYSSA ANNE GOEDDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1251 COLLEGE AVE, ALTON, IL 62002-6735
(618) 463-7849
Mailing address
1251 COLLEGE AVE, ALTON, IL 62002-6735
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013136
IL
Other
Enumeration date
02/21/2020
Last updated
02/21/2020
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