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Individual

SCOTT ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
120 E FLETCHER AVE, STE 100, TAMPA, FL 33612-3407
(813) 978-1300
(813) 972-5395
Mailing address
120 E FLETCHER AVE, STE 100, TAMPA, FL 33612-3407
(813) 978-1300
(813) 972-5395

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
2530
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510429195
TAX ID
FL
Enumeration date
07/28/2005
Last updated
03/04/2016
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