Doctor Name: | JUDITH ANN ANDERSON |
NPI Number: | 1710385455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | OH1499917 |
Business Practice Address: | 5572 Princeton Road Lakota Local School District Liberty Township, OH - 45011 |
Business Phone Number: | 5136441212 |
Business Fax Number: | |
Mailing Address: | 3971 Wess Park Dr, CINCINNATI |
State: | OH |
Postal Code: | 452171931 |
Phone Number: | 5133684780 |
Fax Number: | |
NPI Enumeration Date: | 12/11/2014 |
NPI Last Update Date: | 12/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | OH1499917 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |