Evelyn Louise Andres, SLP
Individual provider Active NPI Speech-Language Pathologist · Fairfax, VA
NPI 1912401753 · NPPES record last updated Mar 19, 2018
Key facts
- NPI
- 1912401753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2203000117 (VA)
- Practice address
- 8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4511 - Phone
- (571) 423-4172
- NPI assigned
- Mar 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2203000117 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2203000117 | VA | Yes |
Addresses
Primary practice location
8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4511
Mailing address
8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4511
Phone (571) 423-4172
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All providers in Fairfax, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.