Basic Information
| Provider Information | |||||||||
| NPI: | 1558704320 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | CELINA | ||||||||
| MiddleName: | JENISE | ||||||||
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| Credential: | M.S., OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2088 TOWNE MILL AVE | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301147526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452629719 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 141 W 73RD ST | ||||||||
| Address2: | APT 1N | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100232916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774073422 | ||||||||
| FaxNumber: | 8774074329 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2013 | ||||||||
| LastUpdateDate: | 12/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 017938 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 006243 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.