Provider Demographics
NPI:1619127735
Name:WEST, ANDREA LYNN I (OT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:WEST
Suffix:I
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 LAPHAM ST
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8821
Mailing Address - Country:US
Mailing Address - Phone:585-410-4894
Mailing Address - Fax:
Practice Address - Street 1:9 LAPHAM ST
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8821
Practice Address - Country:US
Practice Address - Phone:585-410-4894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007088-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist