Individual provider · NPI-1

Andrea Anderson

Counselor, Mental Health · Longmont, CO

NPI number1114585437
StatusActive
Last updated in NPPESJun 1, 2019

Details

NPI
1114585437
Entity type
Individual (NPI-1)
Name
Andrea Anderson
Sex
Female
Sole proprietor
No
Enumeration date
Jun 1, 2019
Last updated
Jun 1, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthNLC.0108060COYes

Practice location

5629 Prospect Rd
Longmont, CO 80503-9047

Phone 406-600-0879

Mailing address

5520 Racquet Ln
Boulder, CO 80303-2941

Phone 406-600-0879

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