Individual
ORETA GAYLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1105 S SUNSWEPT ST, UNION CITY, TN 38261-4370
(800) 632-6074
(866) 341-7509
Mailing address
PO BOX 10414, LARGO, FL 33773-0414
(800) 632-6074
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000004090
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3925799
—
TN
01
—
4051317
BCBS # - PARADIGM
TN
Enumeration date
09/28/2006
Last updated
01/30/2008
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