Individual
MARTHA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4284 DAHLBERG DR, GOLDEN VALLEY, MN 55422-4805
(952) 428-6332
Mailing address
4284 DAHLBERG DR, GOLDEN VALLEY, MN 55422-4805
(952) 428-6332
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1291
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1042746
P1
MN
01
—
113177
UC
MN
01
—
47425
HP
MN
05
—
819633800
—
MN
01
—
908S1AN
BCBS
MN
Enumeration date
07/19/2006
Last updated
08/06/2021
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