Provider Demographics
NPI:1659604874
Name:ANDERSON, ANDREA ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:ANDERSON
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Gender:F
Credentials:PSYD
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Mailing Address - Street 1:2383 UNIVERSITY AVE W STE 200
Mailing Address - Street 2:U.S. BANK BUILDING, SECOND FLOOR
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1603
Mailing Address - Country:US
Mailing Address - Phone:651-644-4100
Mailing Address - Fax:651-644-4885
Practice Address - Street 1:2383 UNIVERSITY AVE W STE 200
Practice Address - Street 2:U.S. BANK BUILDING, SECOND FLOOR
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1603
Practice Address - Country:US
Practice Address - Phone:651-644-4100
Practice Address - Fax:651-644-4885
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNPENDING103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical