Provider Demographics
NPI:1326087693
Name:TETER, KAREN (CCCA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:TETER
Suffix:
Gender:F
Credentials:CCCA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:MUSICANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCCA
Mailing Address - Street 1:2251 N SHORE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-8360
Mailing Address - Country:US
Mailing Address - Phone:715-361-4700
Mailing Address - Fax:
Practice Address - Street 1:2251 N SHORE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-8360
Practice Address - Country:US
Practice Address - Phone:715-361-4700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI414231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41144700Medicaid
WI41144700Medicaid