| Doctor Name: | TERESA RENEE WIMSATT |
| NPI Number: | 1619143823 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | 22001702A |
| Business Practice Address: | 5022 Bent Creek Dr Floyds Knobs, IN - 471199200 |
| Business Phone Number: | 8129237713 |
| Business Fax Number: | 8129237728 |
| Mailing Address: | 5022 Bent Creek Dr, FLOYDS KNOBS |
| State: | IN |
| Postal Code: | 471199200 |
| Phone Number: | 8129237713 |
| Fax Number: | 8129237728 |
| NPI Enumeration Date: | 05/07/2008 |
| NPI Last Update Date: | 05/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235500000X |
| License Number: | 22001702A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |