Provider Demographics
NPI:1366641763
Name:GARRITY, TERESA WACHTER (SLP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:WACHTER
Last Name:GARRITY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:GARRITY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:6900 FERNHILL LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6804
Mailing Address - Country:US
Mailing Address - Phone:919-870-5383
Mailing Address - Fax:
Practice Address - Street 1:6900 FERNHILL LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6804
Practice Address - Country:US
Practice Address - Phone:919-870-5383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC325235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist