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Individual

MR. EDWARD MICHAEL ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1 LINCOLN PARKWAY, SUITE 202, HATTIESBURG, MS 39402
(601) 288-8050
Mailing address
1 LINCOLN PARKWAY, SUITE 202, HATTIESBURG, MS 39402
(601) 288-8050

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
36643
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00122156
MS
Enumeration date
06/14/2006
Last updated
01/15/2008
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