| Doctor Name: | WILLIAM J P ANDERSON |
| NPI Number: | 1316160385 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSAC |
| License Number: | 1255 132 |
| Business Practice Address: | 100 Polk County Plz Suite 50 Balsam Lake, WI - 548109071 |
| Business Phone Number: | 7154858862 |
| Business Fax Number: | 7154858490 |
| Mailing Address: | 28141 Anderson Dr, DANBURY |
| State: | WI |
| Postal Code: | 548308205 |
| Phone Number: | 7158668949 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1255 132 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |