Provider Demographics
NPI:1841422805
Name:STRAIT, ANDREA HALE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:HALE
Last Name:STRAIT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:DAWN
Other - Last Name:HALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1421 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1059
Mailing Address - Country:US
Mailing Address - Phone:859-358-6791
Mailing Address - Fax:859-624-2454
Practice Address - Street 1:1421 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1059
Practice Address - Country:US
Practice Address - Phone:859-358-6791
Practice Address - Fax:859-624-2454
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1463103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist