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HEIDI ANDERSON LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1720560675

Individual Registrant:
 HEIDI  ANDERSON LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
160 DUGGAN AVE  CRESTVIEW, FL 32536-4812 US
Tel: 505-412-5292  Fax: --

Contact information for business:
2816 JACK NICKLAUS WAY  SHALIMAR, FL 32579-2225 US
Tel: 505-412-5292  Fax: --

Registration Information:
NPI: 1720560675
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
FLSW16974

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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