Individual
LARRY D ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2525 N ANKENY BLVD, SUITE 113, ANKENY, IA 50023-4714
(515) 289-9139
(515) 189-9139
Mailing address
2525 N ANKENY BLVD, SUITE 113, ANKENY, IA 50023-4714
(515) 289-9136
(515) 289-9139
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00546
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IB1221
PTAN
IA
Enumeration date
11/15/2006
Last updated
10/01/2010
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