Provider Demographics
NPI:1689153694
Name:ABBENHAUS, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ABBENHAUS
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 1:5567 E 169TH ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9764
Mailing Address - Country:US
Mailing Address - Phone:317-523-1596
Mailing Address - Fax:
Practice Address - Street 1:183 SMOCK DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-2438
Practice Address - Country:US
Practice Address - Phone:317-859-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006834A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist