Individual
MR. MARK R ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
106 N KENOSHA DR, MADISON, WI 53705-2633
(608) 257-7509
Mailing address
106 N KENOSHA DR, MADISON, WI 53705-2633
(608) 257-7509
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3075-125
WI
Other
Enumeration date
02/20/2008
Last updated
02/20/2008
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