Individual
TERESA H LYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
1500 E. MEDICAL CENTER DR., SPC 5312, 1904 TC, OTOLARYNGOLOGY-HEAD AND NECK SURGERY, ANN ARBOR, MI 48109
(734) 936-8051
Mailing address
1500 E. MEDICAL CENTER DR., SPC 5312, 1904 TC, OTOLARYNGOLOGY-HEAD AND NECK SURGERY, ANN ARBOR, MI 48109
(734) 936-8051
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001941
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003878539
—
MI
Enumeration date
10/02/2018
Last updated
10/02/2018
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