Provider Demographics
NPI:1174949564
Name:STRATTON, ANDREA (SLP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:STRATTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 CITADEL DR E STE 250
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5396
Mailing Address - Country:US
Mailing Address - Phone:719-685-7890
Mailing Address - Fax:
Practice Address - Street 1:685 CITADEL DR E STE 250
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5396
Practice Address - Country:US
Practice Address - Phone:719-685-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60447925235Z00000X
COSLP.0003764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist