Provider Demographics
NPI:1881617181
Name:TEOH, AMY P (MS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:P
Last Name:TEOH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2397 HOPKINS FARM CT
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9840
Mailing Address - Country:US
Mailing Address - Phone:336-656-9955
Mailing Address - Fax:
Practice Address - Street 1:2397 HOPKINS FARM CT
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9840
Practice Address - Country:US
Practice Address - Phone:336-656-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003787235Z00000X
NC7861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200544470Medicaid