Provider Demographics
NPI:1114274321
Name:KAY, TRESCHA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRESCHA
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 PULLEY DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-1716
Mailing Address - Country:US
Mailing Address - Phone:715-252-9211
Mailing Address - Fax:
Practice Address - Street 1:6212 TUDOR WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-7067
Practice Address - Country:US
Practice Address - Phone:661-871-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3702-154235Z00000X
CA26319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist