Provider Demographics
NPI:1477876761
Name:MILLER, ANDREA BETTONEY (PT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:BETTONEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 ASPEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2828
Mailing Address - Country:US
Mailing Address - Phone:443-847-7496
Mailing Address - Fax:
Practice Address - Street 1:3 BETHESDA METRO CTR STE B001
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6414
Practice Address - Country:US
Practice Address - Phone:301-986-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist