Individual
KEITH A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 283-1234
(574) 537-2652
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 283-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
34006132A
IN
Other
Enumeration date
06/02/2008
Last updated
08/01/2011
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