Provider Demographics
NPI:1013038157
Name:BEAUCHAMP, TERESE D (MS)
Entity Type:Individual
Prefix:MS
First Name:TERESE
Middle Name:D
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-7834
Mailing Address - Country:US
Mailing Address - Phone:410-668-9198
Mailing Address - Fax:
Practice Address - Street 1:7658A BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-4088
Practice Address - Country:US
Practice Address - Phone:410-668-9198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD177231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist