Provider Demographics
NPI:1487480109
Name:ANDERSEN THERAPY SERVICES
Entity type:Organization
Organization Name:ANDERSEN THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:509-979-6618
Mailing Address - Street 1:511 N ARGONNE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2878
Mailing Address - Country:US
Mailing Address - Phone:509-202-0704
Mailing Address - Fax:
Practice Address - Street 1:511 N ARGONNE RD STE 201
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2878
Practice Address - Country:US
Practice Address - Phone:509-202-0704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical