Provider Demographics
NPI:1881869030
Name:DEW, ANDREA LYNN (M A, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:DEW
Suffix:
Gender:F
Credentials:M A, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 PINEY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2335
Mailing Address - Country:US
Mailing Address - Phone:336-996-5866
Mailing Address - Fax:336-996-5866
Practice Address - Street 1:728 PINEY GROVE RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2335
Practice Address - Country:US
Practice Address - Phone:336-996-5866
Practice Address - Fax:336-996-5866
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3128235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist