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General NPI Number Information
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NPI Number | 1639064173
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Entity Type | Individual
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Provider Name | ANDREW WITHERS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 109 S HURON ST APT 3
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City | YPSILANTI
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State | MI
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Zip | 48197-5453
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Country | US
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Telephone | 734-344-9408
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Fax |
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Provider Business Mailing Address
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Address Line | 109 S HURON ST APT 3
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City | YPSILANTI
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State | MI
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Zip | 48197-5453
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Country | US
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Telephone | 734-344-9408
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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 | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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