| NPI | 1740516731 |
|---|---|
| Other Name | ANDY ANDERSEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: GA 3325) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 3325) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA 3325) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2009-10-26 |