Provider Demographics
NPI:1851935118
Name:GAUCI, TERESA DANIELLE (HIS)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:DANIELLE
Last Name:GAUCI
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31160 FIVE MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3642
Mailing Address - Country:US
Mailing Address - Phone:734-525-3900
Mailing Address - Fax:734-525-4020
Practice Address - Street 1:31160 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3642
Practice Address - Country:US
Practice Address - Phone:734-525-3900
Practice Address - Fax:734-525-4020
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501003225237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty