Provider Demographics
NPI:1992049555
Name:KEVER, ANDREA ELIZABETH (COTA)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:KEVER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1201 DALY DR
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:IN
Mailing Address - Zip Code:46774-1891
Mailing Address - Country:US
Mailing Address - Phone:260-749-0413
Mailing Address - Fax:260-749-2531
Practice Address - Street 1:1201 DALY DR
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:IN
Practice Address - Zip Code:46774-1891
Practice Address - Country:US
Practice Address - Phone:260-749-0413
Practice Address - Fax:260-749-2531
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32000952A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant