Provider Demographics
NPI:1447547922
Name:SCHLEIBAUM, ANDREA MARY (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARY
Last Name:SCHLEIBAUM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARY
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:30 TOZER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5510
Mailing Address - Country:US
Mailing Address - Phone:978-712-9081
Mailing Address - Fax:978-818-6355
Practice Address - Street 1:30 TOZER RD STE 201
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5510
Practice Address - Country:US
Practice Address - Phone:978-712-9081
Practice Address - Fax:978-818-6355
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist