Anderson, Glenn R

Anderson, Glenn R is an sole proprietor health care provider with primary practice located at 614 Loretto Dr , Roseville CA 95661. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Anderson, Glenn R can be contacted via phone (916) 722-4673.

Contact Information

Primary practice address
614 Loretto Dr Roseville CA 95661
Phone: (916) 722-4673
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X IMF 49658 California
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 84277 California

Profile Details

NPI number 1770672362
LBN Legal business name Anderson, Glenn R
Credentials MFTI
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated May 31st, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770672362 NPPES
California Other 84277 LICENSED MFT
California Other IMF 49658 LICENSED MFT

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