Provider Demographics
NPI:1326168865
Name:GAHRE, TERI LEA (MSCCC)
Entity Type:Individual
Prefix:MS
First Name:TERI
Middle Name:LEA
Last Name:GAHRE
Suffix:
Gender:F
Credentials:MSCCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13513 MASHONA AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-8343
Mailing Address - Country:US
Mailing Address - Phone:714-279-4296
Mailing Address - Fax:714-279-5775
Practice Address - Street 1:411 N LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3028
Practice Address - Country:US
Practice Address - Phone:714-279-4296
Practice Address - Fax:714-279-5775
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP5447235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist