Provider Demographics
NPI:1598123903
Name:FINK, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:FINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 JEFFERSON ST SE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-3312
Mailing Address - Country:US
Mailing Address - Phone:301-237-0296
Mailing Address - Fax:
Practice Address - Street 1:2410 JEFFERSON ST SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-3312
Practice Address - Country:US
Practice Address - Phone:301-237-0296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08377235Z00000X
VA2202008098235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist