Provider Demographics
NPI:1982374864
Name:ANDREWS, DEJA ALEXIS
Entity Type:Individual
Prefix:
First Name:DEJA
Middle Name:ALEXIS
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 INDEPENDENCE DR # 8
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1898
Mailing Address - Country:US
Mailing Address - Phone:508-778-1839
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE DR # 8
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1898
Practice Address - Country:US
Practice Address - Phone:508-922-5345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty