Provider Demographics
NPI:1942834304
Name:FREY METZGER, ANDREA LOUISE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LOUISE
Last Name:FREY METZGER
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 1:3427 VERBENA CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3017
Mailing Address - Country:US
Mailing Address - Phone:417-343-6308
Mailing Address - Fax:
Practice Address - Street 1:3455 BRIARGATE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4172
Practice Address - Country:US
Practice Address - Phone:417-343-6308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0016903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health