Provider Demographics
NPI:1396833141
Name:ANDERSON, CURTIS CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:CHARLES
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 11750
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-2008
Mailing Address - Country:US
Mailing Address - Phone:480-834-3505
Mailing Address - Fax:
Practice Address - Street 1:1201 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 11750
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-2008
Practice Address - Country:US
Practice Address - Phone:480-834-3505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1601103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent