Provider Demographics
NPI:1902548464
Name:VANDREW, KATE
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:VANDREW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 AMBERLEIGH DR APT 304
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8021
Mailing Address - Country:US
Mailing Address - Phone:717-903-5479
Mailing Address - Fax:
Practice Address - Street 1:5919 OLEANDER DR STE 119
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4757
Practice Address - Country:US
Practice Address - Phone:910-395-2995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30000551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist