Provider Demographics
NPI:1053443325
Name:SHEVETZ, THERESA SOKOL (AUD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:SOKOL
Last Name:SHEVETZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ECHO
Other - Middle Name:
Other - Last Name:HEARING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3837 ATTUCKS DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-6082
Mailing Address - Country:US
Mailing Address - Phone:614-812-7883
Mailing Address - Fax:614-553-7314
Practice Address - Street 1:3837 ATTUCKS DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6082
Practice Address - Country:US
Practice Address - Phone:614-812-7886
Practice Address - Fax:614-553-7314
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01448237600000X
OHA01366237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH200483645-003OtherBEX
OH200483645-00OtherCAREWORKS
OH200483645-004OtherWEST
OH200483645-002OtherMEDICAL MUTUAL -WOR
OH200483645-002OtherMEDICAL MUTUAL -WOR
OH200483645-004OtherWEST