Provider Demographics
NPI:1760880686
Name:BUTLER, ANDREA DEANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DEANNE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 TECHNOLOGY FOREST PL STE 503
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1206
Mailing Address - Country:US
Mailing Address - Phone:713-903-2271
Mailing Address - Fax:
Practice Address - Street 1:8505 TECHNOLOGY FOREST PL STE 503
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77381-1206
Practice Address - Country:US
Practice Address - Phone:713-903-2271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist