Provider Demographics
NPI:1669282133
Name:MANN, ANDREA (CPRS)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:296 CULLMAN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3022
Mailing Address - Country:US
Mailing Address - Phone:614-462-0236
Mailing Address - Fax:
Practice Address - Street 1:700 BRYDEN RD STE 128
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4839
Practice Address - Country:US
Practice Address - Phone:614-462-0236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005859175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist