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Individual
CODY ANDERSON
Active
Individual
CODY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CDCA.166637
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDCA.166637
CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
Enumeration date
06/19/2018
Last updated
06/19/2018
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