MEDICARE: MRS. ANDREA JAYNE FLINTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP-3551	OH

General Provider Information

NPI Number	:	1215483714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA JAYNE FLINTA

Provider Business Mailing Address
First Line	:	1950 N MALLWAY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-4326
Country	:	US
Telephone Number	:	614-487-5180
Fax Number	:

Provider Business Practice Location Address
First Line	:	1780 BARRINGTON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3839
Country	:	US
Telephone Number	:	614-487-5180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	08/25/2016

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Directions to “ MRS. ANDREA JAYNE FLINTA ” Practice Location

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