Individual
ANDREA REEVES VANDERVORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2910 ROXBURGH DR, ROSWELL, GA 30076-2427
(901) 896-9754
Mailing address
2910 ROXBURGH DR, ROSWELL, GA 30076-2427
(901) 896-9754
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
006718
—
225XP0200X
Pediatric Occupational Therapist
Primary
006718
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006718
OCCUPATIONAL THERAPY
GA
Enumeration date
09/22/2017
Last updated
07/21/2022
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