Individual
DR. DEBRA ANN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1459 E BROADWAY ST, BOLIVAR, MO 65613-2950
(417) 777-5314
(417) 777-5320
Mailing address
PO BOX 347, BOLIVAR, MO 65613-0347
(417) 777-5314
(417) 777-5320
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2005038008
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499186211
—
MO
Enumeration date
05/08/2006
Last updated
09/18/2018
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