Individual
ANDREA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26777 LORAIN RD STE 412, NORTH OLMSTED, OH 44070-3224
(330) 221-1155
Mailing address
26777 LORAIN RD STE 412, NORTH OLMSTED, OH 44070-3224
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.2002687
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265946040
—
OH
Enumeration date
12/01/2017
Last updated
05/10/2021
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