Provider Demographics
NPI:1124804406
Name:BRICE, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13210 ARBOR ISLE DR UNIT 303
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1129
Mailing Address - Country:US
Mailing Address - Phone:708-835-3406
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 1010
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3729
Practice Address - Country:US
Practice Address - Phone:312-219-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist