Individual
MARY K ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5861
Mailing address
673 MASEFIELD CIR, VIRGINIA BEACH, VA 23452-1909
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0904002331
VA
Other
Enumeration date
01/26/2006
Last updated
07/08/2007
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