Anderson, Debra Ann
Anderson, Debra Ann is an sole proprietor health care provider with primary practice located at 1459 E Broadway St , Bolivar MO 65613-2950. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Anderson, Debra Ann can be contacted via phone (417) 777-5314.Contact Information
Primary practice address
1459 E Broadway St
Bolivar MO 65613-2950
Phone: (417) 777-5314
Fax: (417) 777-5320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2005038008 | Missouri |
Profile Details
| NPI number | 1609825785 |
|---|---|
| LBN Legal business name | Anderson, Debra Ann |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 8th, 2006 |
| Last updated | Sep 18th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609825785 | NPPES |
| Missouri | MEDICAID | 499186211 |
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