Provider Demographics
NPI:1609288836
Name:BARTELL, ANDREA (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BARTELL
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 W US HIGHWAY 290
Mailing Address - Street 2:APT 2304
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78736-8012
Mailing Address - Country:US
Mailing Address - Phone:254-634-8505
Mailing Address - Fax:254-781-4312
Practice Address - Street 1:2150 31ST ST
Practice Address - Street 2:APT. 7
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2675
Practice Address - Country:US
Practice Address - Phone:917-602-9488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113195235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist