| Doctor Name: | ANDREA ABDUL-HAQQ |
| NPI Number: | 1942676770 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1303 Windover Run Hanahan, SC - 294108219 |
| Business Phone Number: | 8438147917 |
| Business Fax Number: | 8553622736 |
| Mailing Address: | 1559 Highland Ave Apt 2, CHARLESTON |
| State: | SC |
| Postal Code: | 294123401 |
| Phone Number: | 3012564676 |
| Fax Number: | |
| NPI Enumeration Date: | 08/16/2015 |
| NPI Last Update Date: | 08/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |