Individual
KATHRYN ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5579
(309) 347-4264
Mailing address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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