Doctor Name: | DARBY MCKENNEY ANDERSON |
NPI Number: | 1225498298 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CASAC-T |
License Number: | |
Business Practice Address: | 5700 W Genesee St Suite 118 Camillus, NY - 130313200 |
Business Phone Number: | 3154881641 |
Business Fax Number: | 3154881655 |
Mailing Address: | 5700 W Genesee St, Suite 118 CAMILLUS |
State: | NY |
Postal Code: | 130313200 |
Phone Number: | 3154881641 |
Fax Number: | 3154881655 |
NPI Enumeration Date: | 03/03/2016 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |