Provider Demographics
NPI:1467050666
Name:MINZLER, ANDY
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:MINZLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22664 STATE ROUTE 73
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-6365
Mailing Address - Country:US
Mailing Address - Phone:740-858-6690
Mailing Address - Fax:
Practice Address - Street 1:22664 STATE ROUTE 73
Practice Address - Street 2:
Practice Address - City:WEST PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-6365
Practice Address - Country:US
Practice Address - Phone:740-858-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)