Provider Demographics
NPI:1982927802
Name:NESBITT, TERESA ELIZABETH (MS/CCC/SLP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ELIZABETH
Last Name:NESBITT
Suffix:
Gender:F
Credentials:MS/CCC/SLP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ELIZABETH
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/CCC/SLP
Mailing Address - Street 1:49 WILLOW LOOP
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:KY
Mailing Address - Zip Code:42459-1798
Mailing Address - Country:US
Mailing Address - Phone:270-952-4147
Mailing Address - Fax:
Practice Address - Street 1:49 WILLOW LOOP
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:KY
Practice Address - Zip Code:42459
Practice Address - Country:US
Practice Address - Phone:270-952-4147
Practice Address - Fax:270-952-4147
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY142429235Z00000X
KY3674235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist