Doctor Name: | MRS. MARTHA WILLSON ANDEREGG |
NPI Number: | 1093999575 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904002241 |
Business Practice Address: | 16450 Court St Amelia Court House, VA - 230024870 |
Business Phone Number: | 8045613900 |
Business Fax Number: | 8045613904 |
Mailing Address: | 16450 Court St, AMELIA COURT HOUSE |
State: | VA |
Postal Code: | 230024870 |
Phone Number: | 8045613900 |
Fax Number: | 8045613904 |
NPI Enumeration Date: | 12/20/2007 |
NPI Last Update Date: | 10/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904002241 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |