Provider Demographics
NPI:1366006215
Name:FLOYD, TERESA LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:FLOYD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BYFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-2218
Mailing Address - Country:US
Mailing Address - Phone:813-263-8010
Mailing Address - Fax:
Practice Address - Street 1:46 BYFIELD ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-2218
Practice Address - Country:US
Practice Address - Phone:813-263-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSP00646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist