Provider Demographics
NPI:1043507403
Name:PAZDERA, ANDREA LAURA (PHD, LMFT, CFLE)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LAURA
Last Name:PAZDERA
Suffix:
Gender:F
Credentials:PHD, LMFT, CFLE
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LAURA
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0040
Mailing Address - Country:US
Mailing Address - Phone:970-945-2241
Mailing Address - Fax:970-945-5523
Practice Address - Street 1:405 CASTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-3125
Practice Address - Country:US
Practice Address - Phone:970-920-5555
Practice Address - Fax:970-920-5557
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO971106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist