Provider Demographics
NPI:1912212713
Name:KING, ANDREA (SLP)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2553 RIDGE ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-2211
Mailing Address - Country:US
Mailing Address - Phone:412-716-9800
Mailing Address - Fax:
Practice Address - Street 1:2553 RIDGE ROAD EXT
Practice Address - Street 2:
Practice Address - City:BADEN
Practice Address - State:PA
Practice Address - Zip Code:15005-2211
Practice Address - Country:US
Practice Address - Phone:412-716-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009925235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist