Individual
MATTHEW NEIL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED
Contact information
Practice address
3460 HAMPTON AVE STE 204, SAINT LOUIS, MO 63139-1938
(314) 669-6242
Mailing address
5859 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63109-3571
(314) 669-6242
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15470693
CAQH
—
Enumeration date
12/23/2021
Last updated
01/07/2022
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