Anderson, Deborah Louisa
Anderson, Deborah Louisa is an individual health care provider with primary practice located at 1100 Blythe Blvd , Charlotte NC 28203-5814. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Anderson, Deborah Louisa can be contacted via phone (704) 355-7776.Contact Information
Primary practice address
1100 Blythe Blvd
Charlotte NC 28203-5814
Phone: (704) 355-7776
Fax: (704) 355-4231
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 4119 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 628 | South Carolina |
Profile Details
| NPI number | 1396708863 |
|---|---|
| LBN Legal business name | Anderson, Deborah Louisa |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2006 |
| Last updated | Jul 20th, 2012 - about 14 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 | 1396708863 | NPPES |
| North Carolina | Other | 02154 | BCBSNC |
| North Carolina | MEDICAID | 6001074 | BCBSNC |
| North Carolina | Other | 224686 | BCBSNC |
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