Provider Demographics
NPI:1568073930
Name:ROA, ANDREA STEWART (CHES)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:STEWART
Last Name:ROA
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8808 CALISTOGA SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3776
Mailing Address - Country:US
Mailing Address - Phone:469-296-7757
Mailing Address - Fax:972-627-4229
Practice Address - Street 1:8808 CALISTOGA SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3776
Practice Address - Country:US
Practice Address - Phone:469-296-7757
Practice Address - Fax:972-627-4229
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach