Provider Demographics
NPI:1629116231
Name:KAUL, THERESA (MS)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:KAUL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:MICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:4179 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-4417
Mailing Address - Country:US
Mailing Address - Phone:724-657-8692
Mailing Address - Fax:724-657-9011
Practice Address - Street 1:4179 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-4417
Practice Address - Country:US
Practice Address - Phone:724-657-8692
Practice Address - Fax:724-657-9011
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004828L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist