MEDICARE: CRYSANNIA ANDREWS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1316536386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSANNIA ANDREWS

Provider Business Mailing Address
First Line	:	18307 PRETTY BOY DAM RD
Second Line	:
City	:	PARKTON
State	:	MD
Zip	:	21120-9467
Country	:	US
Telephone Number	:	410-624-8260
Fax Number	:

Provider Business Practice Location Address
First Line	:	8501 LASALLE RD
Second Line	:	SUITE 115
City	:	TOWSON
State	:	MD
Zip	:	21286-2128
Country	:	US
Telephone Number	:	410-337-7772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	09/28/2022

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Directions to “ CRYSANNIA ANDREWS ” Practice Location

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