| Doctor Name: | YVETTE ANDERSON |
| NPI Number: | 1003214156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | CC00801 |
| Business Practice Address: | 762 Transfer Rd Ste 21 Saint Paul, MN - 551141489 |
| Business Phone Number: | 2183558978 |
| Business Fax Number: | |
| Mailing Address: | 4481 County Line Rd, MOOSE LAKE |
| State: | MN |
| Postal Code: | 557679213 |
| Phone Number: | 2183558978 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2014 |
| NPI Last Update Date: | 12/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | CC00801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |