Individual
MRS. MOLLY BEA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. A.
Contact information
Practice address
119A N PARKWAY DR, PEKIN, IL 61554-3932
(309) 642-6763
Mailing address
413 APACHE WAY, GROVELAND, IL 61535-9409
(309) 387-6404
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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