Healthcare Provider Details

I. General information

NPI: 1649180308
Provider Name (Legal Business Name): ANDREA SUSAN PIROCHTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 STABLER ST
LANSING MI
48910-4567
US

IV. Provider business mailing address

610 W OTTAWA ST APT 1410
LANSING MI
48933-1064
US

V. Phone/Fax

Practice location:
  • Phone: 517-755-4423
  • Fax:
Mailing address:
  • Phone: 517-420-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101003169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: