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General NPI Number Information
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NPI Number | 1770525461
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Entity Type | Organization
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Legal Business Name | PAUL W. ANDERSON, INC.
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 49 WESTBURY PARK WAY
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City | BLUFFTON
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State | SC
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Zip | 29910-8824
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Country | US
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Telephone | 843-422-1408
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Fax | 843-815-2023
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Provider Business Mailing Address
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Address Line | 49 WESTBURY PARK WAY
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City | BLUFFTON
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State | SC
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Zip | 29910-8824
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Country | US
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Telephone | 843-422-1408
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Fax | 843-815-2023
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER/OWNER
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Name | MRS. PAMELA P. ANDERSON
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Credential | MSW, LISW-CP
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Telephone | 843-422-1408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1055
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10335
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License Number State | SC
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