Provider Demographics
NPI:1417400128
Name:BICKFORD, ANDREA C (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:C
Last Name:BICKFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6829 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3884
Mailing Address - Country:US
Mailing Address - Phone:703-532-4892
Mailing Address - Fax:
Practice Address - Street 1:6829 ELM ST
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3884
Practice Address - Country:US
Practice Address - Phone:703-532-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31504225100000X
NJ40QA01802400225100000X
VA230521197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist