Provider Demographics
NPI:1144884222
Name:ANDERSON, BRITT (MD)
Entity type:Individual
Prefix:DR
First Name:BRITT
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT. OF PSYCHOLOGY, UNIVERSITY OF WATERLOO
Mailing Address - Street 2:200 UNIVERSITY AVENUE WEST
Mailing Address - City:WATERLOO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N2L3G1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEPT. OF PSYCHOLOGY, UNIVERSITY OF WATERLOO
Practice Address - Street 2:200 UNIVERSITY AVENUE WEST
Practice Address - City:WATERLOO
Practice Address - State:ONTARIO
Practice Address - Zip Code:N2L3G1
Practice Address - Country:CA
Practice Address - Phone:519-888-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI104512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology