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General NPI Number Information
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NPI Number | 1053407635
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Entity Type | Individual
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Provider Name | CHRISTIAN ANDERSON CPC
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 380 COURT ST
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City | ELKO
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State | NV
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Zip | 89801-3158
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Country | US
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Telephone | 915-779-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 349 LAKEPORT DR
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City | SPRING CREEK
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State | NV
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Zip | 89815-6048
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Country | US
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Telephone | 775-299-9906
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 20065
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP0001
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License Number State | NV
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