Individual
RUSSELL A. ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 445-4860
Mailing address
7068 N SUNRISE VIS, PRESCOTT VALLEY, AZ 86314-3416
(928) 772-5477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00007686
WA
Other
Enumeration date
05/18/2006
Last updated
07/08/2007
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