Provider Demographics
NPI:1669064937
Name:DANG, ANDREA QUYNH (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:QUYNH
Last Name:DANG
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 NESTLEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8010
Mailing Address - Country:US
Mailing Address - Phone:407-486-1671
Mailing Address - Fax:
Practice Address - Street 1:1775 NESTLEWOOD TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8010
Practice Address - Country:US
Practice Address - Phone:407-486-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9399390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program