Provider Information for 1801255278
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ANDREA MAXWELL MA, LPC
Sex: Female
NPI: 1801255278
Last Updated: 2023-01-25
Certification Date: 2023-01-25
Certification Date: 2023-01-25
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1801255278 | ||||||||||||
| Enumeration Date | 2016-02-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 107 E ILLINOIS ST MOUNT PLEASANT, MI 48858-2503 United States Phone: 989-773-6904 | Fax: | ||||||||||||
| Primary Practice Address | 107 E ILLINOIS ST MOUNT PLEASANT, MI 48858-2503 United States Phone: 989-773-6904 | Fax: | ||||||||||||
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