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NPI Profile for MINDA ANDERSON in CRYSTAL LAKE, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Student in an Organized Health Care Education/Training Program |
390200000X |
| NPI Number | 1902318652 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/02/2017 | |
| Last updated | 11/02/2017 - About 9 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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MINDA ANDERSON
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MINDA ANDERSON