Individual
ELIZABETH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R-DMT, RYT
Contact information
Practice address
116 PATTERSON RD, HANSCOM AFB, MA 01731-2651
(850) 420-2399
Mailing address
116 PATTERSON RD, HANSCOM AFB, MA 01731-2651
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
225600000X
Dance Therapist
Primary
1564
—
225800000X
Recreation Therapist
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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