Individual
TERESA RUSSELL BOSILJEVAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
11109 SPICEWOOD CLUB DR, AUSTIN, TX 78750-2858
(510) 295-3593
Mailing address
11109 SPICEWOOD CLUB DR, AUSTIN, TX 78750-2858
(510) 295-3593
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
81217
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81217
TX AUDIOLOGY LICENSE NUMBER
TX
Enumeration date
10/09/2008
Last updated
03/27/2023
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