Individual
EDWARD EARL ANDERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
64 POYDRAS ST, HYDE PARK, MA 02136-6419
(617) 637-1478
Mailing address
64 POYDRAS ST, HYDE PARK, MA 02136-6419
(617) 637-1478
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
174H00000X
Health Educator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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