Provider Demographics
NPI:1134513922
Name:HOROWITZ, ANDREW RYAN (LADC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:RYAN
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 SIBLEY MEMORIAL HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55118-2251
Mailing Address - Country:US
Mailing Address - Phone:651-698-7358
Mailing Address - Fax:
Practice Address - Street 1:971 SIBLEY MEMORIAL HWY STE 250
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55118-2251
Practice Address - Country:US
Practice Address - Phone:651-698-7358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303835101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)