Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YP2500X | Professional Counselor | 6078 | LA |
NPI | 1003281056 |
---|---|
Provider Name | Mrs. Tanya J Anderson |
First Address | Franklin, LA 70538-4304 |
Second Address | Franklin, LA 70538-3743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 17/03/2018 |