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General NPI Number Information
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NPI Number | 1003902602
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Entity Type | Individual
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Provider Name | ANDREA C DEVRIES LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 127 W. STREET ROAD SUITE 302
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City | KENNETT SQUARE
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State | PA
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Zip | 19348
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Country | US
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Telephone | 610-444-1841
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 BOTTOM LANE
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City | WEST CHESTER
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State | PA
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Zip | 19382-8070
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Country | US
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Telephone | 610-793-7799
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Fax | 610-793-3899
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW012570
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License Number State | PA
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