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ANDREA ANDERSON
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1114585437
Individual Registrant: ANDREA ANDERSON
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
5629 PROSPECT RD LONGMONT, CO 80503-9047 US
Tel: 406-600-0879 Fax: --
Tel: 406-600-0879 Fax: --
Contact information for business:
5520 RACQUET LN BOULDER, CO 80303-2941 US
Tel: 406-600-0879 Fax: --
Tel: 406-600-0879 Fax: --
Registration Information:
NPI: 1114585437
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | CO | NLC.0108060 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
