Provider Demographics
NPI:1730329020
Name:YOUNG, ANDREA ERIN (HIS, ABOC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ERIN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:HIS, ABOC
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:ERIN
Other - Last Name:PAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HIS, ABOC
Mailing Address - Street 1:1500 S COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-9746
Mailing Address - Country:US
Mailing Address - Phone:419-443-0710
Mailing Address - Fax:
Practice Address - Street 1:1500 S COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-9746
Practice Address - Country:US
Practice Address - Phone:419-443-0710
Practice Address - Fax:419-443-0576
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7183156FX1800X
OH2823237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician