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General NPI Number Information
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NPI Number | 1689193633
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Entity Type | Individual
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Provider Name | KELSIE N TEEHAN
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Gender | Female
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 09/13/2017
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Provider Practice Location Address
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Address Line | 166 PATTERSON AVE STE 8
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4166
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Country | US
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Telephone | 732-842-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 471 CHURCH STREET
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City | BELFORD
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State | NJ
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Zip | 07718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TL-2969
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License Number State | NJ
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