Individual
ANDREW GOTTHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
445 E DUBLIN GRANVILLE RD STE G, WORTHINGTON, OH 43085-3183
(614) 844-3800
(614) 515-5779
Mailing address
445 E DUBLIN GRANVILLE RD, WORTHINGTON, OH 43085-3192
(614) 844-3800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-81711
RBT CERTIFICATE
—
Enumeration date
06/28/2019
Last updated
01/28/2021
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