Provider Demographics
NPI:1164753075
Name:ANDREWS, COLLEEN S (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:S
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04938-3617
Mailing Address - Country:US
Mailing Address - Phone:207-491-2687
Mailing Address - Fax:
Practice Address - Street 1:119 LIVERMORE FALLS RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6241
Practice Address - Country:US
Practice Address - Phone:207-778-6591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist