Individual
DUSTIN B. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
920 SALAZAR RD STE C, TAOS, NM 87571-8225
(575) 519-1869
Mailing address
920 SALAZAR RD STE C, TAOS, NM 87571-8225
(575) 519-1869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73725773
—
NM
Enumeration date
07/14/2020
Last updated
05/11/2023
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