Provider Demographics
NPI:1639477615
Name:NAUS, TERESA E (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:E
Last Name:NAUS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12819 NEWPORT AVE
Mailing Address - Street 2:APT. 1A
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1643
Mailing Address - Country:US
Mailing Address - Phone:917-364-8565
Mailing Address - Fax:
Practice Address - Street 1:12819 NEWPORT AVE
Practice Address - Street 2:APT. 1A
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1643
Practice Address - Country:US
Practice Address - Phone:917-364-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017100-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist