Provider Demographics
NPI:1265128664
Name:DOOLEY, ANDREA M (MS, BC-DMT, LCAT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:MS, BC-DMT, LCAT
Other - Prefix:
Other - First Name:ANDEE
Other - Middle Name:
Other - Last Name:DOOLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, BC-DMT, LCAT
Mailing Address - Street 1:435 E 74TH ST APT 1D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3986
Mailing Address - Country:US
Mailing Address - Phone:347-443-2423
Mailing Address - Fax:
Practice Address - Street 1:435 E 74TH ST APT 1D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3986
Practice Address - Country:US
Practice Address - Phone:347-443-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00282601225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist