Individual
MR. MATTHEW GORDON ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1905B MISSION 66, VICKSBURG, MS 39180-3711
(601) 724-9201
Mailing address
PO BOX 820143, VICKSBURG, MS 39182-0143
(601) 326-3783
(601) 326-3766
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M7209
MS
Other
Enumeration date
07/03/2013
Last updated
07/09/2019
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