Provider Demographics
NPI:1538304365
Name:CURRAN, THERESA ANN (MEDCCCSLP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANN
Last Name:CURRAN
Suffix:
Gender:F
Credentials:MEDCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 SW 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-2982
Mailing Address - Country:US
Mailing Address - Phone:518-335-9023
Mailing Address - Fax:
Practice Address - Street 1:1958 SW 31ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-2982
Practice Address - Country:US
Practice Address - Phone:518-335-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLSA5206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist