Provider Demographics
NPI:1730299538
Name:NOSBISCH, TERI ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:TERI
Middle Name:ANN
Last Name:NOSBISCH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 N ABBOT DRIVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434
Mailing Address - Country:US
Mailing Address - Phone:352-489-9907
Mailing Address - Fax:
Practice Address - Street 1:315 NE 10TH AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429
Practice Address - Country:US
Practice Address - Phone:352-795-7006
Practice Address - Fax:352-795-7008
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5215235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P0387OtherPEDICARE
FL88159600Medicaid
S3034OtherBCBS