Healthcare Provider Details

I. General information

NPI: 1730299538
Provider Name (Legal Business Name): TERI A NOSBISCH-BAILEY MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20561 WALNUT ST
DUNNELLON FL
34431-6799
US

IV. Provider business mailing address

20621 SW 97TH PL
DUNNELLON FL
34431-5810
US

V. Phone/Fax

Practice location:
  • Phone: 352-230-8473
  • Fax: 352-424-7949
Mailing address:
  • Phone: 352-230-8473
  • Fax: 352-424-7949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA5215
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: