Diderika M Telting, PH.D., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01983 Issued in MO

Practice address

1531 E Bradford Pkwy
Suite 205
Springfield, MO 65804-6853

Phone

(417) 883-0043

Fax

(417) 883-0043

NPI assigned

Jun 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Dee M Telting Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1760793483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 E BRADFORD PKWY",
            "address_2": "SUITE 205",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046853",
            "telephone_number": "417-883-0043",
            "fax_number": "417-883-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 E BRADFORD PKWY",
            "address_2": "SUITE 205",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046853",
            "telephone_number": "417-883-0043",
            "fax_number": "417-883-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELTING",
        "first_name": "DIDERIKA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "01983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEE",
            "last_name": "TELTING",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "PH.D., CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Curt A Tebbe, RPH
• Wilconina Tecson, PT
• Morgan Belle Tegart, PHARMD
• Telerad of Mo Account Management, LLC
• Gregory Charles Tellatin, D.D.S.
• Teresa C Tempelmeyer, PHD
• Johnna Tenberge, PA-C
• Rebecca Tennison, LCSW
• Samantha Tennyson
• Eugene M Tenorio, M.D.

• Speech-Language Pathologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.