Provider Demographics
NPI:1720640477
Name:VALENTIN-HICKEY, ANDREA (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:VALENTIN-HICKEY
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 1:250 CARILLON PKWY UNIT 235
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1379
Mailing Address - Country:US
Mailing Address - Phone:727-426-8948
Mailing Address - Fax:
Practice Address - Street 1:558 94TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2406
Practice Address - Country:US
Practice Address - Phone:727-240-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist