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General NPI Number Information
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NPI Number | 1376315861
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Entity Type | Individual
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Provider Name | ANDREW BATHALTER
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Gender | Male
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 25 WHITNEY DR STE 120
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City | MILFORD
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State | OH
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Zip | 45150-8400
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Country | US
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Telephone | 513-654-2773
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Fax |
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Provider Business Mailing Address
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Address Line | 25 WHITNEY DR STE 120
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City | MILFORD
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State | OH
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Zip | 45150-8400
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.185558
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN.195017
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License Number State | OH
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