Provider Demographics
NPI:1477359495
Name:WARRACH, ANDREA (HEALTH COACH)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:WARRACH
Suffix:
Gender:
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 SE DEGAN DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2797
Mailing Address - Country:US
Mailing Address - Phone:646-538-1550
Mailing Address - Fax:
Practice Address - Street 1:832 SE DEGAN DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2797
Practice Address - Country:US
Practice Address - Phone:646-538-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach