Individual
STACY T ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
520 TOPAZ BLVD # 208, DELTA, UT 84624-4100
(435) 406-4902
Mailing address
360 N 525 E, DELTA, UT 84624-4104
(435) 406-4902
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
259947-3501
UT
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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