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Organization
VANDIVIER AND ASSOCIATES PSC
Active
Organization
VANDIVIER AND ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN K. VANDIVIER PHD (OWNER)
(502) 458-7366
Entity
Organization
Contact information
Practice address
903 BAXTER AVE, LOUISVILLE, KY 40204-2046
(502) 458-7366
(502) 458-7362
Mailing address
903 BAXTER AVE, LOUISVILLE, KY 40204-2046
(502) 458-7366
(502) 458-7362
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
NULL
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000060157
ANTHEM BCBS
—
Enumeration date
09/27/2006
Last updated
08/22/2020
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