Provider Demographics
NPI:1225671472
Name:GERE, ANDREA D
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:D
Last Name:GERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 SHEPHERDS WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-8032
Mailing Address - Country:US
Mailing Address - Phone:812-449-1147
Mailing Address - Fax:
Practice Address - Street 1:11401 BLUEGRASS PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2349
Practice Address - Country:US
Practice Address - Phone:888-515-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst