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Individual
MRS. KATIE MARIE ANDERSON
Active
Individual
MRS. KATIE MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC M. COUN
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC3597
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010155545
BLUE SHIELD OF IDAHO
ID
01
—
X6890
BLUE CROSS OF IDAHO
ID
Enumeration date
01/18/2007
Last updated
07/09/2007
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