Provider Demographics
NPI:1295237451
Name:BREWER, ANDREA LEIGH (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEIGH
Last Name:BREWER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 OWENSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-9407
Mailing Address - Country:US
Mailing Address - Phone:434-293-9304
Mailing Address - Fax:
Practice Address - Street 1:1610 OWENSVILLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-9407
Practice Address - Country:US
Practice Address - Phone:434-293-9304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist