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General NPI Number Information
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NPI Number | 1023484623
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Entity Type | Individual
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Provider Name | ANYEA ANDERSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 580 W CROSSVILLE RD
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City | ROSWELL
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State | GA
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Zip | 30075-7505
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Country | US
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Telephone | 770-992-2386
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Fax |
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Provider Business Mailing Address
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Address Line | 375 MORNING SPRINGS WALK
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2682
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Country | US
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Telephone | 609-977-0274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW006741
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License Number State | GA
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