Provider Demographics
NPI:1649229899
Name:KRUEGER, ANDREA ELLEN (MED, MFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ELLEN
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:MED, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4801
Mailing Address - Country:US
Mailing Address - Phone:702-696-9490
Mailing Address - Fax:702-796-9490
Practice Address - Street 1:2649 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4801
Practice Address - Country:US
Practice Address - Phone:702-696-9490
Practice Address - Fax:702-796-9490
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0439106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist