Healthcare Provider Details

I. General information

NPI: 1760821110
Provider Name (Legal Business Name): ANDREA ANN WOJTOWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDREN'S DRIVE DEPARTMENT OF PSYCHOLOGY
COLUMBUS OH
43205
US

IV. Provider business mailing address

700 CHILDREN'S DRIVE DEPARTMENT OF PSYCHOLOGY
COLUMBUS OH
43205
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-4700
  • Fax: 614-722-4718
Mailing address:
  • Phone: 614-722-4700
  • Fax: 614-722-4718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP.07938
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: