Provider Demographics
NPI:1194013334
Name:ANDERSON, MARY E (MA, LAMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20288 HIGHWAY 15 N STE 100
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5684
Mailing Address - Country:US
Mailing Address - Phone:320-587-2326
Mailing Address - Fax:320-234-6358
Practice Address - Street 1:20288 HIGHWAY 15 N STE 100
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5684
Practice Address - Country:US
Practice Address - Phone:320-587-2326
Practice Address - Fax:320-234-6358
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2189106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist