Provider Demographics
NPI:1831213859
Name:VANESTENBERG, ANDREA MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:VANESTENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SHERATON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7555
Mailing Address - Country:US
Mailing Address - Phone:724-420-5731
Mailing Address - Fax:724-420-5732
Practice Address - Street 1:56 SHERATON DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7555
Practice Address - Country:US
Practice Address - Phone:724-420-5731
Practice Address - Fax:724-420-5732
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004206101YP2500X
OH6404103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional