Provider Demographics
NPI:1134469497
Name:ETTER, ANDREW C (MS, BC-HIS, ACA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:C
Last Name:ETTER
Suffix:
Gender:M
Credentials:MS, BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 W SILVERBELL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1327
Mailing Address - Country:US
Mailing Address - Phone:248-620-3525
Mailing Address - Fax:248-620-3545
Practice Address - Street 1:1060 W SILVERBELL RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-1327
Practice Address - Country:US
Practice Address - Phone:248-620-3525
Practice Address - Fax:248-620-3545
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501005097237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist