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NPI Code Detail

MEDICARE: CELENA ANDERSON

MEDICARE: CELENA ANDERSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1700605276
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELENA ANDERSON
Provider Business Mailing Address
First Line : PO BOX 259
Second Line :
City : SHALIMAR
State : FL
Zip : 32579-0259
Country : US
Telephone Number : 850-362-6824
Fax Number :
Provider Business Practice Location Address
First Line : 3355 ADDISON DR STE A
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-7065
Country : US
Telephone Number : 850-362-6824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2024
Last Update Date : 05/19/2026

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Directions to “ CELENA ANDERSON ” Practice Location

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