Provider Demographics
NPI:1104017581
Name:ANDRIACCHI, CATHY (SLP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:ANDRIACCHI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 PROGRESSO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-3271
Mailing Address - Country:US
Mailing Address - Phone:702-355-0784
Mailing Address - Fax:792-233-1205
Practice Address - Street 1:5451 PROGRESSO ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-3271
Practice Address - Country:US
Practice Address - Phone:702-355-0784
Practice Address - Fax:792-233-1205
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP 280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist