Provider Demographics
NPI:1447963665
Name:ANDREWS, FAY
Entity type:Individual
Prefix:
First Name:FAY
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:FAY
Other - Middle Name:
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4552 LEE JACKSON HWY
Mailing Address - Street 2:
Mailing Address - City:COLEMAN FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:24536-2506
Mailing Address - Country:US
Mailing Address - Phone:954-657-1086
Mailing Address - Fax:
Practice Address - Street 1:4552 LEE JACKSON HWY
Practice Address - Street 2:
Practice Address - City:COLEMAN FALLS
Practice Address - State:VA
Practice Address - Zip Code:24536-2506
Practice Address - Country:US
Practice Address - Phone:954-657-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019015526225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist