Provider Demographics
NPI:1750767562
Name:ANDES SPILSBURY, ANDREA (LMFT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:ANDES SPILSBURY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 N GOLIAD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-7204
Mailing Address - Country:US
Mailing Address - Phone:310-493-7445
Mailing Address - Fax:
Practice Address - Street 1:1213 N GOLIAD ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-7204
Practice Address - Country:US
Practice Address - Phone:310-493-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203661106H00000X
CA83892106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist