Provider Demographics
NPI:1891231544
Name:ANDREWS, MARISA VINEYARD (CGC)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:VINEYARD
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-286-2400
Mailing Address - Fax:314-286-2455
Practice Address - Street 1:4444 FOREST PARK AVE
Practice Address - Street 2:DIV OB REPRODUCTIVE ENDOCRINOLOGY, STE 3100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2212
Practice Address - Country:US
Practice Address - Phone:314-286-2400
Practice Address - Fax:314-286-2455
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00012170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS