Provider Demographics
NPI:1871752709
Name:ANDER, RITA LEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:LEE
Last Name:ANDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 NW 2ND AVENUE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4861
Mailing Address - Country:US
Mailing Address - Phone:561-999-9890
Mailing Address - Fax:
Practice Address - Street 1:4710 NW 2ND AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4861
Practice Address - Country:US
Practice Address - Phone:561-999-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00034051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical