Healthcare Provider Details

I. General information

NPI: 1073227062
Provider Name (Legal Business Name): ANDREA NICOLE GARRETT BA,MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 E EXCHANGE ST FL 6
AKRON OH
44308-1541
US

IV. Provider business mailing address

4014 MEDINA RD # 1006
AKRON OH
44333-4568
US

V. Phone/Fax

Practice location:
  • Phone: 234-334-3293
  • Fax:
Mailing address:
  • Phone: 330-328-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberRS100984
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRS100984
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: