Individual
MR. EVAN TULLIS ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2825 S MERIDIAN RD STE 150, MERIDIAN, ID 83642-7960
(208) 297-9495
(208) 955-2490
Mailing address
2825 S MERIDIAN RD STE 150, MERIDIAN, ID 83642-7960
(208) 297-9495
(208) 955-2490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34856
ID
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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