Individual
MRS. ROBERTA JEANNE DERMODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
3917 WHITFIELD DR, SWANSEA, IL 62226-1022
(618) 235-1009
Mailing address
3917 WHITFIELD DR, SWANSEA, IL 62226-1022
(618) 235-1009
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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