Individual
HEATHER JEAN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 DAKOTA ST, CRYSTAL LAKE, IL 60012-3742
(847) 220-8428
Mailing address
1050 WAKIGAN TRL, ALGONQUIN, IL 60102-3704
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.102249
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150.102249
LSW
IL
Enumeration date
02/12/2020
Last updated
02/12/2020
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