Individual
MS. KATHLEEN LYNN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSP, NCSP, LPES
Contact information
Practice address
2233 DEERFIELD DR, FORT MILL, SC 29715-6941
(803) 548-2527
Mailing address
2233 DEERFIELD DR, FORT MILL, SC 29715-6941
(803) 548-8039
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4610
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4610
LLI LICENSE
SC
Enumeration date
06/12/2013
Last updated
06/12/2013
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