Healthcare Provider Details

I. General information

NPI: 1942546460
Provider Name (Legal Business Name): ANDREA HEDRICK-CAVAIOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 BEAR CORBITT RD
BEAR DE
19701-1323
US

IV. Provider business mailing address

925 BEAR CORBITT RD
BEAR DE
19701-1323
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2400
  • Fax: 302-454-5444
Mailing address:
  • Phone: 302-454-2400
  • Fax: 302-454-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO1-0001079
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: