Individual
SYDNEY F ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
637 N COLLEGE AVE, BLOOMINGTON, IN 47404-3871
(812) 331-2800
Mailing address
637 N COLLEGE AVE, BLOOMINGTON, IN 47404-3871
(812) 331-2800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20040198A
IN
103TC0700X
Clinical Psychologist
Primary
20040198A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000316234
ANTHEM
—
05
—
100331430A
—
IN
Enumeration date
03/14/2006
Last updated
04/29/2009
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