NPI 1639858707 · live from the CMS NPI Registry
Kyra Anderson
Marriage & Family Therapist in Fayetteville, GA. National Provider Identifier 1639858707, active.
NPI record
| NPI | 1639858707 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 500 Lanier Ave W Ste 908, Fayetteville, GA 30214 |
| Practice phone | 770-769-5322 |
| Mailing address | 159 Aubree Way, Mcdonough, GA 30252 |
| Enumerated | July 14, 2023 |
| Last updated | July 14, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Marriage & Family Therapist primary | 106H00000X | AMFT000711 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.