Provider Demographics
NPI:1174894455
Name:NORCROSS, ANDREA CHRISTINA (LCAT, MT-BC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:CHRISTINA
Last Name:NORCROSS
Suffix:
Gender:F
Credentials:LCAT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:59 KIDS WAY
Mailing Address - Street 2:
Mailing Address - City:ALTONA
Mailing Address - State:NY
Mailing Address - Zip Code:12910
Mailing Address - Country:US
Mailing Address - Phone:518-569-8320
Mailing Address - Fax:
Practice Address - Street 1:427 MARGARET ST.
Practice Address - Street 2:NORTH COUNTRY KIDS
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-561-3803
Practice Address - Fax:518-561-3805
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001052221700000X
06635225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist