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Individual
KOREN ANDERSON
Active
Individual
KOREN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC006369
PA
101YP2500X
Professional Counselor
Primary
PC006369
PA
Other
Enumeration date
10/01/2012
Last updated
01/28/2017
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