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ANDREA ANDERSON

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1114585437

Individual Registrant:
 ANDREA  ANDERSON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5629 PROSPECT RD  LONGMONT, CO 80503-9047 US
Tel: 406-600-0879  Fax: --

Contact information for business:
5520 RACQUET LN  BOULDER, CO 80303-2941 US
Tel: 406-600-0879  Fax: --

Registration Information:
NPI: 1114585437
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
CONLC.0108060

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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