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General NPI Number Information
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NPI Number | 1881884781
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Entity Type | Individual
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Provider Name | CYNTHIA J. ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | US HWY 160 & NAVAJO ROUTE 25 - RED MESA
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City | TEECNOSPOS
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State | AZ
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Zip | 86514
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Country | US
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Telephone | 505-368-6401
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Fax | 505-368-6431
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Provider Business Mailing Address
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Address Line | HCR 6100 BOX 30
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City | TEECNOSPOS
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State | AZ
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Zip | 86514
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Country | US
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Telephone | 505-368-6401
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Fax | 505-368-6431
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 343562-3502
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License Number State | UT
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