Provider Demographics
NPI:1477864536
Name:FIERRO, ANDREA MARIE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:FIERRO
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:EDIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:75 ORISKANY BLVD.
Mailing Address - Street 2:WHITESBORO CENTRAL SCHOOL DISTRICT
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-9998
Mailing Address - Country:US
Mailing Address - Phone:315-266-3100
Mailing Address - Fax:315-768-9770
Practice Address - Street 1:75 ORISKANY BLVD.
Practice Address - Street 2:WHITESBORO CENTRAL SCHOOL DISTRICT
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-9998
Practice Address - Country:US
Practice Address - Phone:315-266-3100
Practice Address - Fax:315-768-9770
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017587235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist