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NPI Code Detail

MEDICARE: DALE R ANDERSON LP

MEDICARE: DALE R ANDERSON LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist781KS
2101YA0400XAddiction (Substance Use Disorder) Counselor509KS

General Provider Information

NPI Number : 1427154350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALE R ANDERSON LP
Provider Business Mailing Address
First Line : 1600 N LORRAINE ST STE 202
Second Line :
City : HUTCHINSON
State : KS
Zip : 67501-5600
Country : US
Telephone Number : 620-663-7595
Fax Number : 620-513-5098
Provider Business Practice Location Address
First Line : 1600 N LORRAINE ST STE 202
Second Line :
City : HUTCHINSON
State : KS
Zip : 67501-5600
Country : US
Telephone Number : 620-663-7595
Fax Number : 620-513-5098
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 03/26/2021

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Directions to “ DALE R ANDERSON LP” Practice Location

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