Individual
MELISSA VANDERHEIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CARVER LN, EAST PEORIA, IL 61611-3052
(309) 282-6704
Mailing address
110 CARVER LN, EAST PEORIA, IL 61611-3052
(309) 282-6704
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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