MRS. Jackie Lou Anderson
NPI #1295004406 in Machesney Park, Illinois
Provider Information
- NPI Number
- 1295004406
- Entity Type
- Individual
- Name
- MRS. Jackie Lou Anderson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Developmental Therapist
- Enumeration Date
- Dec 16, 2011
- Last Updated
- Dec 16, 2011
Practice Location
- Address
- 101 SHORELAND RD
- City
- Machesney Park
- State
- Illinois
- ZIP Code
- 61115-2833
- Phone
- (815) 633-1173
Specialties & Taxonomy Codes
| Specialty |
|---|
| Developmental Therapist |
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