Provider Demographics
NPI:1295115152
Name:OVERTON, ANDREA BUCKER (AUD)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:BUCKER
Last Name:OVERTON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LAUREN
Other - Last Name:BUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2226 NELSON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8923
Mailing Address - Country:US
Mailing Address - Phone:984-974-4479
Mailing Address - Fax:919-490-5818
Practice Address - Street 1:2226 NELSON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8923
Practice Address - Country:US
Practice Address - Phone:984-974-4479
Practice Address - Fax:919-490-5818
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11432231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist