Provider Demographics
NPI:1154796647
Name:ABELN, ANDREA DEE (SLP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DEE
Last Name:ABELN
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 1:1180 BIEKER RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-6614
Mailing Address - Country:US
Mailing Address - Phone:314-287-8380
Mailing Address - Fax:
Practice Address - Street 1:10047 DIAMOND RD
Practice Address - Street 2:
Practice Address - City:CADET
Practice Address - State:MO
Practice Address - Zip Code:63630-9581
Practice Address - Country:US
Practice Address - Phone:573-438-4982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015037209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist