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General NPI Number Information
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NPI Number | 1033582861
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Entity Type | Individual
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Provider Name | KAYLA ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 06/27/2017
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Provider Practice Location Address
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Address Line | 623 N CENTRAL AVE
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City | SIDNEY
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State | MT
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Zip | 59270-4216
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Country | US
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Telephone | 406-488-3001
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Fax | 406-483-3003
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Provider Business Mailing Address
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Address Line | PO BOX 626
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City | SIDNEY
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State | MT
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Zip | 59270-0626
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2647
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License Number State | MT
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