Provider Demographics
NPI:1740091545
Name:TOBIAS, ANDREA L (PSYD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:TOBIAS
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:KLEIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:129 SALINE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1146
Mailing Address - Country:US
Mailing Address - Phone:517-402-6373
Mailing Address - Fax:
Practice Address - Street 1:129 SALINE RIVER DR
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1146
Practice Address - Country:US
Practice Address - Phone:517-402-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014059103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist