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Individual

MARY E ANDRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
108 W MARKET, BLOOMINGTON, IL 61701
(309) 827-5351
(309) 829-6808
Mailing address
309 E NORTHTOWN RD, NORMAL, IL 61761
(309) 454-5634

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
IL

Other

Enumeration date
10/06/2006
Last updated
07/08/2007
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