| Doctor Name: | MR. PERRY J ANDERSON |
| NPI Number: | 1457574527 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | 6798-123 |
| Business Practice Address: | 100 Polk County Plz Suite 50 Balsam Lake, WI - 548109071 |
| Business Phone Number: | 7154858445 |
| Business Fax Number: | 7154858490 |
| Mailing Address: | 440 105th St, AMERY |
| State: | WI |
| Postal Code: | 540014010 |
| Phone Number: | 7152685165 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 08/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6798-123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |