Provider Demographics
NPI:1639508807
Name:THATCHER, ANDREA CHRISTINE (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:CHRISTINE
Last Name:THATCHER
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10021 WATER WORKS LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-5304
Mailing Address - Country:US
Mailing Address - Phone:813-677-6444
Mailing Address - Fax:813-677-7999
Practice Address - Street 1:10021 WATER WORKS LN
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5304
Practice Address - Country:US
Practice Address - Phone:813-677-6444
Practice Address - Fax:813-677-7999
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8912103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist