Individual
DR. DEBORAH LOUISA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-7776
(704) 355-4231
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-7776
(704) 355-4231
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4119
NC
103TC0700X
Clinical Psychologist
628
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02154
BCBSNC
NC
01
—
224686
MEDCOST
NC
05
—
6001074
—
NC
Enumeration date
04/07/2006
Last updated
07/20/2012
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