Healthcare Provider Details

I. General information

NPI: 1689291114
Provider Name (Legal Business Name): ANDREA VRETAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S BROADWAY ST
AKRON OH
44308-1529
US

IV. Provider business mailing address

340 S BROADWAY ST
AKRON OH
44308-1529
US

V. Phone/Fax

Practice location:
  • Phone: 330-323-5399
  • Fax:
Mailing address:
  • Phone: 330-323-5399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF.2600604
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM.2100238-TRNE
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: