Provider Demographics
NPI:1962949545
Name:FLOTH, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:FLOTH
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 1:1177 HARRINGTON AVE NE APT 304
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3069
Mailing Address - Country:US
Mailing Address - Phone:253-224-8589
Mailing Address - Fax:
Practice Address - Street 1:1177 HARRINGTON AVE NE #304
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056
Practice Address - Country:US
Practice Address - Phone:253-224-8589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst