Provider Demographics
NPI:1417278037
Name:WILKINS, TERESA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ANN
Last Name:WILKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1142
Mailing Address - Country:US
Mailing Address - Phone:717-632-8400
Mailing Address - Fax:
Practice Address - Street 1:100 W EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1142
Practice Address - Country:US
Practice Address - Phone:717-632-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4740101YP2500X
PAPC010409101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional