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 |