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General NPI Number Information
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NPI Number | 1720490097
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Entity Type | Organization
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Legal Business Name | TERESA TROWER
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 3715 SAN JOSE PL
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City | JACKSONVILLE
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State | FL
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Zip | 32257-8866
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Country | US
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Telephone | 904-868-0717
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Fax |
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Provider Business Mailing Address
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Address Line | 12241 MARBON ESTATES LN E
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City | JACKSONVILLE
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State | FL
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Zip | 32223-3299
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Country | US
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Telephone | 904-260-1486
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | TERESA L TROWER
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Credential | LMHC
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Telephone | 904-260-1486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | FL
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