Healthcare Provider Details

I. General information

NPI: 1285083410
Provider Name (Legal Business Name): ANDREA EADS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 E GRAND RIVER AVE
HOWELL MI
48843-8503
US

IV. Provider business mailing address

2280 E GRAND RIVER AVE
HOWELL MI
48843-8503
US

V. Phone/Fax

Practice location:
  • Phone: 810-394-3645
  • Fax:
Mailing address:
  • Phone: 517-546-4126
  • Fax: 517-546-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802092850
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: