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1174938542
ADISA ANDERSON
BERKELEY, CA
NPI
1174938542
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-06-24
Last Update Date
2014-06-24
Business Address
-- ADISA ANDERSON B.A.
2222 BANCROFT WAY #4300
BERKELEY, CA 94720-4300
Phone number: 510-642-2000
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Mailing Address
-- ADISA ANDERSON B.A.
1890 NE MERMAN DR APT A103
PULLMAN, WA 99163-5084
Phone number: 562-331-0808
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