Provider Demographics
NPI:1326456922
Name:KHOUW, TERESA ROLLINS (LPC, RPT)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ROLLINS
Last Name:KHOUW
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 WYNDMERE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-7809
Mailing Address - Country:US
Mailing Address - Phone:972-365-8165
Mailing Address - Fax:972-223-1525
Practice Address - Street 1:201 AMANDA LN
Practice Address - Street 2:SUITE 102
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1390
Practice Address - Country:US
Practice Address - Phone:972-365-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-27
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional