Individual
DAVID MICHAEL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
24799 FOREST BLVD, FOREST LAKE, MN 55025-7215
(651) 257-4406
(651) 257-4406
Mailing address
PO BOX 536, FOREST LAKE, MN 55025-0536
(651) 257-4406
(651) 257-4406
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1063
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172491
UBH
MN
01
—
6274978
BHP
MN
01
—
96D29AN
BLUEPLUS
MN
Enumeration date
10/24/2006
Last updated
07/08/2007
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