| Kent W Anderson Phd Pc | |
|
545 W 465 N Suite 130 Providence UT 84332-8003 | |
| (435) 752-7627 | |
| (435) 752-7802 |
| Full Name | Kent W Anderson Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 545 W 465 N, Providence, Utah |
| Authorized Official Name and Position | Kent W Anderson (PRESIDENT/OWNER) |
| Authorized Official Contact | 4357527627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kent W Anderson Phd Pc 545 W 465 N Suite 130 Providence UT 84332-8003 Ph: (435) 752-7627 | Kent W Anderson Phd Pc 545 W 465 N Suite 130 Providence UT 84332-8003 Ph: (435) 752-7627 |
| NPI Number | 1255662425 |
|---|---|
| Provider Enumeration Date | 01/27/2010 |
| Last Update Date | 01/27/2010 |
| Medicare PECOS PAC ID | 2961546783 |
|---|---|
| Medicare Enrollment ID | O20100217000687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255662425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 324469-2501 (Utah) | Primary |
| Provider Name | Kent W Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932231016 PECOS PAC ID: 6507900321 Enrollment ID: I20100217000680 |
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