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Individual
PAUL T ANDERSON
Active
Individual
PAUL T ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.024927
IL
1041C0700X
Clinical Social Worker
6801121536
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.024927
LICENSE NUMBER
IL
Enumeration date
10/10/2022
Last updated
09/05/2026
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