Individual provider · NPI-1

Garland Anderson, MS

Counselor, Mental Health · Port St Lucie, FL

NPI number1528580313
StatusActive
Last updated in NPPESJul 13, 2017

Details

NPI
1528580313
Entity type
Individual (NPI-1)
Name
Mr. Garland Anderson
Credential
MS
Sex
Male
Sole proprietor
No
Enumeration date
Jul 13, 2017
Last updated
Jul 13, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthIMH15887FLYes

Practice location

2100 Se Hillmoor Dr Ste 205
Port St Lucie, FL 34952-8057

Phone 772-252-9318

Mailing address

3644 Sw Masilunas St
Port St Lucie, FL 34953-5247

Phone 772-252-9318

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