Provider Demographics
NPI:1245340371
Name:HOEHN, ANDREA THERESA (MOT OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:THERESA
Last Name:HOEHN
Suffix:
Gender:F
Credentials:MOT OTR/L
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:THERESA
Other - Last Name:PAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:2907 WOODS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-5729
Mailing Address - Country:US
Mailing Address - Phone:573-474-2304
Mailing Address - Fax:
Practice Address - Street 1:1420 W ASHLEY RD
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-2112
Practice Address - Country:US
Practice Address - Phone:660-882-6115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006002993225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO221801509Medicare ID - Type Unspecified