Provider Demographics
NPI:1811426372
Name:SEAVER, ANDREA S (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:S
Last Name:SEAVER
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 1:100 MOUNT CLINTON PIKE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-2507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3653 LINVILLE EDOM RD
Practice Address - Street 2:
Practice Address - City:LINVILLE
Practice Address - State:VA
Practice Address - Zip Code:22834-2342
Practice Address - Country:US
Practice Address - Phone:540-833-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty