| Doctor Name: | DEBORAH J ANDERSON |
| NPI Number: | 1174734156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ICADC |
| License Number: | 39 |
| Business Practice Address: | 120 W 1st St Watonga, OK - 737723643 |
| Business Phone Number: | 5806232545 |
| Business Fax Number: | 5806232668 |
| Mailing Address: | 120 W 1st St, Po Box 569 WATONGA |
| State: | OK |
| Postal Code: | 737723643 |
| Phone Number: | 5806232545 |
| Fax Number: | 5806232668 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 39 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |