Provider Demographics
NPI:1447804554
Name:MOTT, ANDREA DRUMMOND
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DRUMMOND
Last Name:MOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-4965
Mailing Address - Country:US
Mailing Address - Phone:781-312-1393
Mailing Address - Fax:
Practice Address - Street 1:20 WINTER ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-4965
Practice Address - Country:US
Practice Address - Phone:781-312-1393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health