Provider Demographics
NPI:1396910428
Name:ROUSE, TERI SHEAL (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TERI
Middle Name:SHEAL
Last Name:ROUSE
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 1:1704 NC 39 HWY N
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-8329
Mailing Address - Country:US
Mailing Address - Phone:919-496-7323
Mailing Address - Fax:919-496-3046
Practice Address - Street 1:1704 NC 39 HWY N
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-8329
Practice Address - Country:US
Practice Address - Phone:919-496-7323
Practice Address - Fax:919-496-3046
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3782235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist