Provider Demographics
NPI:1164063772
Name:MULSON, TERRI LEE (MS)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LEE
Last Name:MULSON
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 1:814 RAINBOW DRIVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5511
Mailing Address - Country:US
Mailing Address - Phone:518-339-3723
Mailing Address - Fax:
Practice Address - Street 1:814 RAINBOW DRIVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5511
Practice Address - Country:US
Practice Address - Phone:518-339-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004046-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist