Individual
ANDREW GRANT PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 CLEVELAND AVE NW, CANTON, OH 44702-1836
(330) 455-0374
(330) 453-6716
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 453-6716
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
405300000X
Prevention Professional
Primary
OCPSA.161356
OH
Other
Enumeration date
09/13/2018
Last updated
10/25/2019
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