Provider Demographics
NPI:1366588600
Name:DANNER, THERESA ANN (ST)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ANN
Last Name:DANNER
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11003 WAR ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-7922
Mailing Address - Country:US
Mailing Address - Phone:859-250-9024
Mailing Address - Fax:859-689-0198
Practice Address - Street 1:11003 WAR ADMIRAL DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7922
Practice Address - Country:US
Practice Address - Phone:859-250-9024
Practice Address - Fax:859-689-0198
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSP7947235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist