Provider Demographics
NPI:1497830012
Name:SHIVE, TERRI L (AUD)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:L
Last Name:SHIVE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-226-5070
Mailing Address - Fax:419-998-4548
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804
Practice Address - Country:US
Practice Address - Phone:419-226-5070
Practice Address - Fax:419-998-4548
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00894231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist