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General NPI Number Information
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NPI Number | 1295952299
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Entity Type | Individual
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Provider Name | THEODORE SCOTT ANDERSON SR. L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 102-A ORANGE ST. SUITE 104
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City | OXFORD
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State | NC
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Zip | 27565
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Country | US
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Telephone | 919-690-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 ED HARRIS RD
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City | OXFORD
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State | NC
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Zip | 27565-7308
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Country | US
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Telephone | 919-693-3566
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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 | 3729
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License Number State | NC
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