Doctor Name: | DR. GWENELLYN ANDERSON |
NPI Number: | 1215130091 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED.D. |
License Number: | |
Business Practice Address: | 3000 Market St Ne Salem, OR - 973011882 |
Business Phone Number: | 5039107372 |
Business Fax Number: | |
Mailing Address: | 2735 High St Se, SALEM |
State: | OR |
Postal Code: | 973024446 |
Phone Number: | 5035852856 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |