Provider Demographics
NPI:1831640994
Name:MUHA, TERRI L (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:L
Last Name:MUHA
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:L
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1500 W. JEFFERSON STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45506
Mailing Address - Country:US
Mailing Address - Phone:937-505-2820
Mailing Address - Fax:937-505-2979
Practice Address - Street 1:631 S YELLOW SPRINGS STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45506
Practice Address - Country:US
Practice Address - Phone:937-505-4159
Practice Address - Fax:937-322-5246
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-0491235Z00000X
OHSP0419235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist