MEDICARE: ANDREA S SEAVER M.S. CCC SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202003178	VA

General Provider Information

NPI Number	:	1811426372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA S SEAVER M.S. CCC SLP

Provider Business Mailing Address
First Line	:	100 MOUNT CLINTON PIKE
Second Line	:
City	:	HARRISONBURG
State	:	VA
Zip	:	22802-2507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3653 LINVILLE EDOM RD
Second Line	:
City	:	LINVILLE
State	:	VA
Zip	:	22834-2342
Country	:	US
Telephone Number	:	540-833-6916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	06/08/2017

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