Provider Demographics
NPI:1760589485
Name:POCIECHA, ANDREA L (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:L
Last Name:POCIECHA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:13838 GRANADA WAY
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5058
Mailing Address - Country:US
Mailing Address - Phone:952-432-4366
Mailing Address - Fax:
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7522231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist