Individual provider · NPI-1

Kanesha Anderson

Community/Behavioral Health · Peoria, AZ

NPI number1245892199
StatusActive
Last updated in NPPESJul 1, 2019

Details

NPI
1245892199
Entity type
Individual (NPI-1)
Name
Kanesha Anderson
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 1, 2019
Last updated
Jul 1, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral HealthBh5607AZYes

Practice location

8910 W Monroe St
Peoria, AZ 85345-6440

Phone 623-248-4347 · Fax 623-248-4355

Mailing address

12384 W Hazelwood St
Avondale, AZ 85392-4275

Phone 623-418-5132

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Community/Behavioral Health providers in Peoria, AZ