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General NPI Number Information
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NPI Number | 1396085908
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Entity Type | Individual
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Provider Name | TERESA JEANNE LEAR LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 14950 WASHINGTON ST STE 201
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City | HAYMARKET
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State | VA
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Zip | 20169-2906
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Country | US
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Telephone | 571-248-6442
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Fax |
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Provider Business Mailing Address
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Address Line | 6711 PINCHOT LN
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City | HAYMARKET
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State | VA
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Zip | 20169-2746
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Country | US
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Telephone | 703-313-0040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001448
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License Number State | VA
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