Individual
KYLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2458 STETZER RD, BUCYRUS, OH 44820-2066
(419) 562-2000
Mailing address
1404 PARK AVE W, ONTARIO, OH 44906-2719
(419) 522-6191
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
—
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/18/2017
Last updated
03/19/2026
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