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General NPI Number Information
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NPI Number | 1316858749
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Entity Type | Individual
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Provider Name | GYLLIEN RUBY NOELLE ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 164 W WATER ST
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City | OAK HARBOR
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State | OH
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Zip | 43449-1332
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Country | US
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Telephone | 419-707-3033
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Fax | 419-707-3033
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Provider Business Mailing Address
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Address Line | 216 S MERCER RD APT 1
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City | BOWLING GREEN
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State | OH
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Zip | 43402-3360
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Country | US
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Telephone | 330-945-0609
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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 |
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License Number State |
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