Provider Demographics
NPI:1356578322
Name:MCNAMARA, ANDREA NICOLE (CF-SLP, MS)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:NICOLE
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:CF-SLP, MS
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:NICOLE
Other - Last Name:ST. MARIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:2701 N ROCKY POINT DR
Mailing Address - Street 2:SUITE 650
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5917
Mailing Address - Country:US
Mailing Address - Phone:800-892-0640
Mailing Address - Fax:800-892-0648
Practice Address - Street 1:2701 N ROCKY POINT DR
Practice Address - Street 2:SUITE 650
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5917
Practice Address - Country:US
Practice Address - Phone:800-892-0640
Practice Address - Fax:800-892-0648
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist