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General NPI Number Information
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NPI Number | 1053643668
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Entity Type | Individual
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Provider Name | ANDREA WILKINSON OHLE LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2010
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 74 FIRE ISLAND AVENUE SUITE 104
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City | BABYLON
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State | NY
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Zip | 11702
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Country | US
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Telephone | 631-258-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 74 FIRE ISLAND AVENUE SUITE 104
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City | BABYLON
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State | NY
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Zip | 11702
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Country | US
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Telephone | 631-258-1611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 06-000741
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License Number State | NY
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