Individual
TINA ANN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 3RD AVE, ROCK ISLAND, IL 61201-8840
(309) 779-7500
(309) 779-7505
Mailing address
3412 6TH AVE, ROCK ISLAND, IL 61201-2010
(630) 946-4999
(309) 779-7505
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
11/18/2020
Last updated
01/02/2025
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