Individual
ANNIE BERNADETTE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DR
Contact information
Practice address
95-782 WIKAO STREET, N-201, MILILANI, HI 96789-5089
(714) 702-9577
Mailing address
6121B HERON AVE, EWA BEACH, HI 96706-3341
(808) 489-2486
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
10/15/2010
Last updated
03/11/2024
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