Provider Demographics
NPI:1558738765
Name:ANDREWS, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ANDREWS
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 1:715 DISCOVERY BLVD STE 311
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2290
Mailing Address - Country:US
Mailing Address - Phone:512-260-6990
Mailing Address - Fax:512-260-6991
Practice Address - Street 1:715 DISCOVERY BLVD STE 311
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2290
Practice Address - Country:US
Practice Address - Phone:512-260-6990
Practice Address - Fax:512-260-6991
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110779235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist