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DR. EVAN JOSEPH ANDERSON PHD
Clinical Child & Adolescent >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1134765159
Individual Registrant:DR. EVAN JOSEPH ANDERSON PHD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1201 BURLEYSON RD DALTON, GA 30720-3028 US
Tel: 706-226-8900 Fax: --
Tel: 706-226-8900 Fax: --
Contact information for business:
1201 BURLEYSON RD DALTON, GA 30720 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1134765159
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103TC2200X | Behavioral Health & Social Service Providers Psychologist Clinical Child & Adolescent | GA | PS-P00257 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
