Provider Demographics
NPI:1710040985
Name:ANDERSON, HALI (PT)
Entity Type:Individual
Prefix:
First Name:HALI
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 JERMOR LANE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-876-8076
Mailing Address - Fax:410-876-3818
Practice Address - Street 1:431 E RIDGEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771
Practice Address - Country:US
Practice Address - Phone:301-829-6811
Practice Address - Fax:301-829-6623
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist