Individual
MS. TIERA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
837 LYNAHVEN DRIVE, GASTONIA, NC 28052
(216) 903-6256
Mailing address
837 LYNHAVEN DR, GASTONIA, NC 28052-7611
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
036371
NC
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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