Provider Demographics
NPI:1831319581
Name:BELLIS, TERESA JAMES (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:JAMES
Last Name:BELLIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-2036
Mailing Address - Country:US
Mailing Address - Phone:605-624-8353
Mailing Address - Fax:605-677-5767
Practice Address - Street 1:414 E CLARK ST
Practice Address - Street 2:DEPARTMENT OF COMMUNICATION DISORDERS
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-2307
Practice Address - Country:US
Practice Address - Phone:605-677-6201
Practice Address - Fax:605-677-5767
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD37231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist