Provider Demographics
NPI:1669172649
Name:CAPRANOS, ANDREA RENEE (MA, SLP-CCC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:RENEE
Last Name:CAPRANOS
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8024 DISCOVERY FALLS TRL
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2261
Mailing Address - Country:US
Mailing Address - Phone:941-626-6305
Mailing Address - Fax:
Practice Address - Street 1:8024 DISCOVERY FALLS TRL
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2261
Practice Address - Country:US
Practice Address - Phone:941-626-6305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYSP993235Z00000X
NMSLP6147235Z00000X
FLSA13780235Z00000X
NVSP-2451235Z00000X
VA2202010525235Z00000X
NC15262235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist