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Individual

MR. RAY ANDERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPH, M.ED.

Contact information

Practice address
2012 HIGHWAY 160 W, SUITE 16, FORT MILL, SC 29708-8401
(980) 404-2365
(803) 403-8916
Mailing address
2012 HIGHWAY 160 W, 16, FORT MILL, SC 29708-8401
(314) 518-0042
(803) 403-8916

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
104100000X
Social Worker
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker
174H00000X
Health Educator

Other

Enumeration date
12/10/2013
Last updated
07/01/2015
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