Provider Demographics
NPI:1407137243
Name:WINCHIP, ANDREA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WINCHIP
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 1:6110 STATE ROUTE 8
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12817-2417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6110 STATE ROUTE 8
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:NY
Practice Address - Zip Code:12817-2417
Practice Address - Country:US
Practice Address - Phone:518-494-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009807235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist