Provider Demographics
NPI:1710408323
Name:HOLLENKAMP, TERESA ANNE (MA, SLP-CCC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANNE
Last Name:HOLLENKAMP
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANNE
Other - Last Name:WIESMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2315 HEATHER HILL BLVD N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-2666
Mailing Address - Country:US
Mailing Address - Phone:513-474-4123
Mailing Address - Fax:513-474-4130
Practice Address - Street 1:3530 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1331
Practice Address - Country:US
Practice Address - Phone:513-245-0100
Practice Address - Fax:513-245-2372
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.3459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist