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General NPI Number Information
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NPI Number | 1326234717
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Entity Type | Individual
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Provider Name | DANA K ANDERSON JR. LMFT
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Gender | Male
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 11/11/2012
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Provider Practice Location Address
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Address Line | 2949 W STATE ROAD 434 SUITE 200
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City | LONGWOOD
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State | FL
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Zip | 32779-4458
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Country | US
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Telephone | 407-221-0366
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Fax | 310-347-4260
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Provider Business Mailing Address
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Address Line | 1845 PINE BAY DR
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City | LAKE MARY
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State | FL
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Zip | 32746-7102
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Country | US
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Telephone | 407-444-0473
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2565
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License Number State | FL
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