Individual provider · NPI-1

Forrest Anderson

Counselor, Professional · Nampa, ID

NPI number1679227615
StatusActive
Last updated in NPPESJun 25, 2024

Details

NPI
1679227615
Entity type
Individual (NPI-1)
Name
Forrest Anderson
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 8, 2022
Certification date
Jun 25, 2024
Last updated
Jun 25, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional10163IDYes

Practice location

3307 Caldwell Blvd Ste 104
Nampa, ID 83651-6403

Phone 208-465-4833 · Fax 208-467-2654

Mailing address

1712 Dearborn St
Caldwell, ID 83605-5039

Phone 253-720-5888

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