Individual
DR. CAROL V ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2060 E 25TH ST, IDAHO FALLS, ID 83404-6490
(208) 522-3404
Mailing address
2060 E 25TH ST, IDAHO FALLS, ID 83404-6490
(208) 522-3404
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-202288
ID
Other
Enumeration date
03/14/2007
Last updated
02/06/2009
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