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Individual

SAMUEL NEAL ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CIT

Contact information

Practice address
11408 LAKE SHERWOOD AVE N STE A, BATON ROUGE, LA 70816-0421
(225) 261-7143
Mailing address
624 CONNELL PARK LN, BATON ROUGE, LA 70806-6534
(225) 300-4850

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4018
LA
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8050569
LA
Enumeration date
11/19/2018
Last updated
04/11/2022
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