| NPI | 1356328272 |
|---|---|
| Other Name | CLARENCE LEROY ANDERSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: UT 821686511205) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: UT 821686511205) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2015-06-09 |