MEDICARE: LARIA ANDREWS

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	1041C0700X	Clinical Social Worker	P021080	NC

General Provider Information

NPI Number	:	1104653146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARIA ANDREWS

Provider Business Mailing Address
First Line	:	7612 BROOKWOOD VALLEY LN
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-9722
Country	:	US
Telephone Number	:	980-279-7836
Fax Number	:

Provider Business Practice Location Address
First Line	:	7612 BROOKWOOD VALLEY LN
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-9722
Country	:	US
Telephone Number	:	980-279-7836
Fax Number	:

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

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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Directions to “ LARIA ANDREWS ” Practice Location

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