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NPI Profile for STEFANI ANDERSON in CHAMPAIGN, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X |
| NPI Number | 1619455813 |
|
| Status | Active | |
| Credentials | BS | |
| Entity | Individual | |
| Enumeration date | 07/31/2018 | |
| Last updated | 04/12/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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STEFANI ANDERSON
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STEFANI ANDERSON, BS