Individual
MARK ERIC ANDERSON
Active
Individual
MARK ERIC ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LP LMFT
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 3081
MN
106H00000X
Marriage & Family Therapist
1064
MN
Other
Enumeration date
09/02/2006
Last updated
04/01/2014
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