Provider Demographics
NPI:1447346010
Name:ESTELL, ANDREA (PSYD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:ESTELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LAWSON RD.
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:CT
Mailing Address - Zip Code:06076
Mailing Address - Country:US
Mailing Address - Phone:860-974-3210
Mailing Address - Fax:
Practice Address - Street 1:12 LAWSON RD.
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:CT
Practice Address - Zip Code:06076
Practice Address - Country:US
Practice Address - Phone:860-974-3210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional