Individual
DAVEDA T ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
4214 E MAIN ST, COLUMBUS, OH 43213-3028
(614) 334-6903
(833) 833-3067
Mailing address
4214 E MAIN ST, COLUMBUS, OH 43213-3028
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.184658
OH
171M00000X
Case Manager/Care Coordinator
CDCA.181496
OH
175T00000X
Peer Specialist
0003015
OH
Other
Enumeration date
03/28/2022
Last updated
03/23/2024
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