Individual
KYLE CLARK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
A1608108
AR
101YP2500X
Professional Counselor
Primary
P1810134
AR
171M00000X
Case Manager/Care Coordinator
—
AR
Other
Enumeration date
01/30/2007
Last updated
06/10/2019
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