Teresa Wallace, MS, F-AAA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AT005862 Issued in PA

Practice address

1700 S Lincoln Ave
Lebanon, PA 17042-7529

Phone

(717) 272-6621

Fax

(717) 228-5970

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Easter Seals Central Texas Inc

  • Early Intervention Provider Agency
  • Austin, TX
  • NPI 1013991017

  Audiologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497709703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 RAMBLEWOOD LN",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170429407",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LINCOLN AVE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427529",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "MS, F-AAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT005862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP.
• Melanie A Walborn, MTBC
• Joseph Jude Walden, MD
• Gabrielle Nicole Wall, PMHNP-BC
• Shyann Wallace, ATC, LAT
• Kaitlin Walsh
• Jeremy A Walters, M.D.
• Ryan Walters, DMD
• Chelsea L Walus, LCSW, CCM
• Diptish Wankhade, MD

• Audiologist in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Audiologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.