NPI 1053709675

Tavia Lynne Anderson

Practitioner Driver Bloomington, MN

Practice location

Address: 2400 W 102nd St APT 101, Bloomington, MN 55431-3359
Phone: (612) 203-4535
Fax: (952) 217-4427

Registered specialties (6)

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence J430163453007 (MN)

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Social Worker

Behavioral Health & Social Service Providers Taxonomy 104100000X

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Home Health Agency

Agencies Taxonomy 251E00000X

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Counselor

Behavioral Health & Social Service Providers Taxonomy 101Y00000X

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Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X

Registry record

NPI: 1053709675
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Jan 2015
Record last updated: 17 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.