| Doctor Name: | JEFFREY M. ANDERSON |
| NPI Number: | 1699944595 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MHRT-C & CADC |
| License Number: | CAC4176 |
| Business Practice Address: | 88 Fox St Madawaska, ME - 047561352 |
| Business Phone Number: | 2077286341 |
| Business Fax Number: | 2077287762 |
| Mailing Address: | 88 Fox St, MADAWASKA |
| State: | ME |
| Postal Code: | 047561352 |
| Phone Number: | 2077286341 |
| Fax Number: | 2077287762 |
| NPI Enumeration Date: | 02/25/2008 |
| NPI Last Update Date: | 06/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CAC4176 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |