MR. Russell Anderson, LSW

NPI #1972965937 in Idaho Falls, Idaho

Provider Information

NPI Number: 1972965937
Entity Type: Individual
Name: MR. Russell Anderson, LSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LSW
Enumeration Date: Mar 28, 2016
Last Updated: Mar 28, 2016

Practice Location

Address: 150 SHOUP AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83402-3657
Phone: (208) 522-5700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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