Provider Demographics
NPI:1730209461
Name:IRWIN, TERESA ROBINSON (MS, BC-HIS, ACA)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ROBINSON
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MS, BC-HIS, ACA
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:MAYES
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4641 MELODY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3532
Mailing Address - Country:US
Mailing Address - Phone:804-240-2181
Mailing Address - Fax:
Practice Address - Street 1:9699 W BROAD ST
Practice Address - Street 2:SUITE C
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-4116
Practice Address - Country:US
Practice Address - Phone:804-264-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101000328237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist