Provider Demographics
NPI:1134353782
Name:ANDRADE, YVETTE (SLP)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:
Last Name:ANDRADE
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 1:4125 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2601
Mailing Address - Country:US
Mailing Address - Phone:718-655-0261
Mailing Address - Fax:718-654-7930
Practice Address - Street 1:4125 CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2601
Practice Address - Country:US
Practice Address - Phone:718-655-0261
Practice Address - Fax:718-654-7930
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019011-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist