Provider Demographics
NPI:1427370295
Name:SKINNER, TERESA ANN (PHD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:SKINNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1005 GREEN LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689
Mailing Address - Country:US
Mailing Address - Phone:727-399-1715
Mailing Address - Fax:727-210-6945
Practice Address - Street 1:7130 SEMINOLE BLVD.
Practice Address - Street 2:SEMINOLE PROFESSIONAL CENTRE
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772
Practice Address - Country:US
Practice Address - Phone:727-277-2746
Practice Address - Fax:727-210-6945
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty