Provider Demographics
NPI:1699507830
Name:TERHUNE, ANSLEY (SLP)
Entity type:Individual
Prefix:
First Name:ANSLEY
Middle Name:
Last Name:TERHUNE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 E 11TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-6219
Mailing Address - Country:US
Mailing Address - Phone:706-766-4548
Mailing Address - Fax:
Practice Address - Street 1:600 EAGLE LAKE TRL
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2207
Practice Address - Country:US
Practice Address - Phone:706-450-8776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA013220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist