Provider Demographics
NPI:1982880753
Name:SMITH, ANDREA JEAN (MS, LCGC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 S CEDAR CREST BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6263
Mailing Address - Country:US
Mailing Address - Phone:610-402-9069
Mailing Address - Fax:610-402-2754
Practice Address - Street 1:1240 S CEDAR CREST BLVD STE 310
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-402-8787
Practice Address - Fax:610-402-2754
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS