Provider Demographics
NPI:1063734747
Name:OHLER, ANDREA RAE (MSW, CSW)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:RAE
Last Name:OHLER
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5159 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-8755
Mailing Address - Country:US
Mailing Address - Phone:616-312-2594
Mailing Address - Fax:
Practice Address - Street 1:5159 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-8755
Practice Address - Country:US
Practice Address - Phone:616-312-2594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2523861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical