Provider Demographics
NPI:1467787333
Name:ANDREWS, AMY (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 HENTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1371
Mailing Address - Country:US
Mailing Address - Phone:419-866-5275
Mailing Address - Fax:419-866-5663
Practice Address - Street 1:222 E FRONT ST
Practice Address - Street 2:STE 135 B
Practice Address - City:PEMBERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43450-7105
Practice Address - Country:US
Practice Address - Phone:419-287-3399
Practice Address - Fax:419-287-3355
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4720235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2526654Medicaid
OH366724Medicare PIN