Individual
MR. GAYLE G ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
2850 W CLAY ST STE 255, SAINT CHARLES, MO 63301-2579
(636) 699-0872
Mailing address
11 BAY OAKS CT, LAKE SAINT LOUIS, MO 63367-2127
(636) 699-0872
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010008296
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2010008296
—
MO
Enumeration date
03/18/2010
Last updated
01/31/2011
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