Provider Demographics
NPI:1194139147
Name:CARELLA, ANDREA LYN (SLP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYN
Last Name:CARELLA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:LYN
Other - Last Name:DEFRANCESCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:16 HUMES CT
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2263
Mailing Address - Country:US
Mailing Address - Phone:203-887-4465
Mailing Address - Fax:
Practice Address - Street 1:239 S UNION ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1610
Practice Address - Country:US
Practice Address - Phone:203-887-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist