Healthcare Provider Details

I. General information

NPI: 1962514844
Provider Name (Legal Business Name): ALISON L ANDERSON M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3846 MASTHEAD NE BLDG C
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

30 PINON RIDGE RD
TIJERAS NM
87059-7363
US

V. Phone/Fax

Practice location:
  • Phone: 505-798-9300
  • Fax: 505-798-0808
Mailing address:
  • Phone: 505-286-1317
  • Fax: 505-286-1317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: