Basic Information
Provider Information
NPI: 1114324191
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BLOWERS
FirstName: ANDREW
MiddleName: PIERCE
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 399318
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941399318
CountryCode: US
TelephoneNumber: 8665234268
FaxNumber:  
Practice Location
Address1: 444 S 44TH ST
Address2:  
City: OMAHA
State: NE
PostalCode: 681313727
CountryCode: US
TelephoneNumber: 4025598863
FaxNumber: 4025595737
Other Information
ProviderEnumerationDate: 11/19/2014
LastUpdateDate: 04/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X  Y Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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