Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1235796566 |
---|---|
Provider Name | Ms. Africa C Anderson |
First Address | Wheaton, IL 60189-2000 |
Second Address | Wheaton, IL 60189-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2019 |
Last Update Date | 22/05/2019 |