Provider Demographics
NPI:1215060785
Name:TEAGUE, LOU ANNE (MA,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LOU ANNE
Middle Name:
Last Name:TEAGUE
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PROMONTORY POINT DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-6002
Mailing Address - Country:US
Mailing Address - Phone:919-469-0843
Mailing Address - Fax:
Practice Address - Street 1:301 PROMONTORY POINT DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-6002
Practice Address - Country:US
Practice Address - Phone:919-469-0843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist