Provider Demographics
NPI:1992444681
Name:TELATOVICH, ANDREA KATHLEEN (AUD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:KATHLEEN
Last Name:TELATOVICH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S RANCHO DR STE A8
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4871
Mailing Address - Country:US
Mailing Address - Phone:702-605-9133
Mailing Address - Fax:702-678-6159
Practice Address - Street 1:501 S RANCHO DR STE A8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4871
Practice Address - Country:US
Practice Address - Phone:702-605-9133
Practice Address - Fax:702-678-6159
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-3302231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist