Provider Demographics
NPI:1821677501
Name:RICHARDSON, ANDREA (BCBA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2085 LITTLEMORE DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-5269
Mailing Address - Country:US
Mailing Address - Phone:901-220-0587
Mailing Address - Fax:
Practice Address - Street 1:1880 OLD HIGHWAY 51 S STE F
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:TN
Practice Address - Zip Code:38011-8025
Practice Address - Country:US
Practice Address - Phone:901-290-3916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst