Individual
ANDREA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5629 PROSPECT RD, LONGMONT, CO 80503-9047
(406) 600-0879
Mailing address
5520 RACQUET LN, BOULDER, CO 80303-2941
(406) 600-0879
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NLC.0108060
CO
Other
Enumeration date
06/01/2019
Last updated
06/01/2019
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