| Doctor Name: | TRISHA ANDERSON |
| NPI Number: | 1013287259 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.S.W., I.A.D.C. |
| License Number: | 11143 |
| Business Practice Address: | 515 E Broadway Council Bluffs, IA - 515034419 |
| Business Phone Number: | 7123221407 |
| Business Fax Number: | |
| Mailing Address: | 515 E Broadway, COUNCIL BLUFFS |
| State: | IA |
| Postal Code: | 515034419 |
| Phone Number: | 7123255635 |
| Fax Number: | 7123226833 |
| NPI Enumeration Date: | 01/05/2012 |
| NPI Last Update Date: | 03/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 11143 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |