Provider Demographics
NPI:1922613629
Name:STAUFFER, ANDREA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:HAROLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:424 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1523
Mailing Address - Country:US
Mailing Address - Phone:412-741-4087
Mailing Address - Fax:412-741-6808
Practice Address - Street 1:424 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1523
Practice Address - Country:US
Practice Address - Phone:412-741-4087
Practice Address - Fax:412-741-6808
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013838225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist