Provider Demographics
NPI:1770892622
Name:CAIN, TERESA L
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:L
Last Name:CAIN
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:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:CANDOR
Mailing Address - State:NY
Mailing Address - Zip Code:13743-0145
Mailing Address - Country:US
Mailing Address - Phone:607-659-3935
Mailing Address - Fax:
Practice Address - Street 1:97 OWEGO RD
Practice Address - Street 2:
Practice Address - City:CANDOR
Practice Address - State:NY
Practice Address - Zip Code:13743-1614
Practice Address - Country:US
Practice Address - Phone:607-659-3935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist