Provider Demographics
NPI:1053460428
Name:TROWER, TERESA L (MA LMHC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:L
Last Name:TROWER
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12241 MARBON ESTATES LN E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-3299
Mailing Address - Country:US
Mailing Address - Phone:904-260-1486
Mailing Address - Fax:904-880-0802
Practice Address - Street 1:3715 SAN JOSE PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8866
Practice Address - Country:US
Practice Address - Phone:904-260-1486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0002000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health