Provider Demographics
NPI:1760115760
Name:SLOSSER WORTH, ANDREA EILEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:EILEEN
Last Name:SLOSSER WORTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:EILEEN
Other - Last Name:SLOSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3272 N HUMBOLDT BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2252
Mailing Address - Country:US
Mailing Address - Phone:920-344-1697
Mailing Address - Fax:
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist