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General NPI Number Information
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NPI Number | 1346729969
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Entity Type | Individual
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Provider Name | ANDREA CREIGH SHIPMAN CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 2506 LITHIA PINECREST RD STE 135
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City | VALRICO
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State | FL
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Zip | 33596-5036
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Country | US
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Telephone | 813-391-8398
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Fax |
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Provider Business Mailing Address
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Address Line | 7830 BROADSTONE LOOP APT 207
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City | TAMPA
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State | FL
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Zip | 33625-2461
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Country | US
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Telephone |
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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