Provider Demographics
NPI:1790102341
Name:HAUBNER, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HAUBNER
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 1:8939 EAGLEVIEW DR
Mailing Address - Street 2:UNIT 4
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6712
Mailing Address - Country:US
Mailing Address - Phone:513-319-7983
Mailing Address - Fax:
Practice Address - Street 1:1361 HUFFMAN AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-3016
Practice Address - Country:US
Practice Address - Phone:937-542-5946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist