Provider Demographics
NPI:1518557040
Name:FRIEROTT, THERESA ONG (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ONG
Last Name:FRIEROTT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 YOUNG AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5646
Mailing Address - Country:US
Mailing Address - Phone:901-262-0982
Mailing Address - Fax:
Practice Address - Street 1:2111 YOUNG AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-5646
Practice Address - Country:US
Practice Address - Phone:901-262-0982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist