Provider Information for 1235295890
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Ms. TRACEE LYN ANDERSON LCSW
Sex: Female
NPI: 1235295890
Last Updated: 2020-02-27
Certification Date: 2020-02-27
Certification Date: 2020-02-27
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1235295890 | ||||||||||||
| Enumeration Date | 2006-12-28 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 101 E. BROADWAY SUITE 310 MISSOULA, MT 59802-4510 United States Phone: 406-214-5133 | Fax: | ||||||||||||
| Primary Practice Address | 101 E. BROADWAY SUITE 310 MISSOULA, MT 59802-4510 United States Phone: 406-214-5133 | Fax: | ||||||||||||
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