Individual
DR. EVAN J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1204 W MAIN ST, CHARLOTTESVILLE, VA 22903-2824
(434) 924-8184
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810008529
VA
103TC2200X
Clinical Child & Adolescent Psychologist
PS-P00257
GA
Other
Enumeration date
11/25/2019
Last updated
07/11/2024
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