Provider Demographics
NPI:1487718094
Name:HOPE, ANDREA W (MSP, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:W
Last Name:HOPE
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 AUBURNDALE LN
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9600
Mailing Address - Country:US
Mailing Address - Phone:803-230-1529
Mailing Address - Fax:
Practice Address - Street 1:1226 AUBURNDALE LN
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9600
Practice Address - Country:US
Practice Address - Phone:803-230-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC333235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC426508Medicare ID - Type Unspecified