Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PY6002 | FL |
NPI | 1134169261 |
---|---|
Provider Name | Dr. Elizabeth Mae Anderson |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-4816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 18/04/2019 |