Provider Demographics
NPI:1780883751
Name:CUMMINGS, ANDREA DAWN (BS)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DAWN
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:411 EASTGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-7316
Mailing Address - Country:US
Mailing Address - Phone:918-540-3680
Mailing Address - Fax:
Practice Address - Street 1:130 W STEVE OWENS BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-7629
Practice Address - Country:US
Practice Address - Phone:918-542-2845
Practice Address - Fax:918-542-2848
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)