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General NPI Number Information
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NPI Number | 1033682315
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Entity Type | Individual
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Provider Name | PATRICE ANDERSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 3400 N 29TH AVENUE
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City | HOLLYWOOD
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State | FL
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Zip | 33020
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Country | US
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Telephone | 954-276-3400
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Fax | 954-965-6444
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Provider Business Mailing Address
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Address Line | 871 W OAKLAND PARK BLVD
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City | WILTON MANORS
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State | FL
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Zip | 33311-1731
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Country | US
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Telephone | 954-600-3329
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Fax | 954-565-5624
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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