Individual
JEFFREY D. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
502 W RANDOLPH AVE, ENID, OK 73701-3828
(580) 242-2421
Mailing address
4809 W WOOD RD, WAUKOMIS, OK 73773-0799
(580) 758-3599
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1935
OK
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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