Provider Demographics
NPI:1073966404
Name:ANDREASSI, KELLY (OT/R)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ANDREASSI
Suffix:
Gender:F
Credentials:OT/R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 DELSEA DR N STE 130
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1438
Mailing Address - Country:US
Mailing Address - Phone:856-371-9521
Mailing Address - Fax:
Practice Address - Street 1:816 DELSEA DR N STE 130
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1438
Practice Address - Country:US
Practice Address - Phone:856-371-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program