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General NPI Number Information
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NPI Number | 1720498264
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Entity Type | Individual
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Provider Name | MR. MICHAEL SCOTT ANDERSON
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Gender | Male
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 4210 INDEPENDENCE DR
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City | SCHNECKSVILLE
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State | PA
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Zip | 18078-2580
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Country | US
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Telephone | 610-769-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 TREMONT CIR
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City | WHITEHALL
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State | PA
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Zip | 18052-6931
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Country | US
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Telephone | 610-821-0218
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BH000172
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License Number State | PA
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