Provider Demographics
NPI:1508424367
Name:BUCHHEISTER, TERESA ANN
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:BUCHHEISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3718 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-6311
Mailing Address - Country:US
Mailing Address - Phone:443-759-2446
Mailing Address - Fax:
Practice Address - Street 1:2700 GWYNNS FALLS PKWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-1959
Practice Address - Country:US
Practice Address - Phone:443-396-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist