Individual
JUDITH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
117 N ASH ST, SALLISAW, OK 74955-4201
(918) 235-0440
Mailing address
117 N ASH ST, SALLISAW, OK 74955-4201
(918) 235-0440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
175
OK
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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