Provider Demographics
NPI:1619029253
Name:METTLER, ANDREA ROXANA (OTR)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:ROXANA
Last Name:METTLER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:ROXANA
Other - Last Name:METTLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:2505 TARRYTOWN MALL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4515
Mailing Address - Country:US
Mailing Address - Phone:713-974-6723
Mailing Address - Fax:
Practice Address - Street 1:1635 BLALOCK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-7320
Practice Address - Country:US
Practice Address - Phone:713-465-9465
Practice Address - Fax:713-827-0935
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106707225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist