Individual
ANDREW A COLONNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S0031362
OH
1041C0700X
Clinical Social Worker
Primary
S.0031362
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0311981
—
OH
Enumeration date
01/04/2011
Last updated
06/06/2021
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