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Individual

RUSSELL ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2810 E CAUSEWAY APPROACH, MANDEVILLE, LA 70448-3502
(985) 875-2340
Mailing address
101 LAFITTE ALY, SLIDELL, LA 70461-2717
(985) 643-9491

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1539PL
LA

Other

Enumeration date
06/02/2020
Last updated
06/02/2020
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