Provider Demographics
NPI:1235991779
Name:PRICE, ANDREA NICOLE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:PRICE
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 1:402 INDIAN HILL CT
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-2067
Mailing Address - Country:US
Mailing Address - Phone:678-558-4775
Mailing Address - Fax:
Practice Address - Street 1:137 NATIONAL PLZ STE 300
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1153
Practice Address - Country:US
Practice Address - Phone:240-360-1917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty