Individual
TERESA ANN LANCASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., SLP-CCC
Contact information
Practice address
311 N 10TH ST, COEUR D ALENE, ID 83814-4280
(208) 664-2659
Mailing address
493 E IOWA AVE, HAYDEN, ID 83835-9275
(208) 304-0236
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1632
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51270
—
ND
Enumeration date
01/25/2007
Last updated
01/14/2009
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