Theresa Ann White, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Westport, NY

NPI 1841502192 · NPPES record last updated Jul 1, 2010

Key facts

NPI
1841502192
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
019567-1 (NY)
Practice address
150 Redmond Rd
Westport, NY 12993-2529
Phone
(518) 536-2537
Fax
(518) 837-2009
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
019567-1NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 019567-1 NY Yes

Addresses

Primary practice location

150 Redmond Rd
Westport, NY 12993-2529

Mailing address

150 Redmond Rd
Westport, NY 12993-2529
Phone (518) 536-2537

Other providers in Westport, NY

All providers in Westport, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.