Provider Demographics
NPI:1366643215
Name:LOEB, ANDREA LIPPMAN (PSY,D)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LIPPMAN
Last Name:LOEB
Suffix:
Gender:F
Credentials:PSY,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 S DIXIE HWY
Mailing Address - Street 2:SUITE 1305
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2927
Mailing Address - Country:US
Mailing Address - Phone:305-662-2686
Mailing Address - Fax:305-668-9503
Practice Address - Street 1:1390 S DIXIE HWY
Practice Address - Street 2:SUITE 1305
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2927
Practice Address - Country:US
Practice Address - Phone:305-662-2686
Practice Address - Fax:305-668-9503
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5818103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent