Provider Demographics
NPI:1477769693
Name:HARRIS, TERESA ANN (LMHC PSYD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHC PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2194 HWY A1A
Mailing Address - Street 2:SUITE 203
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4930
Mailing Address - Country:US
Mailing Address - Phone:321-576-2299
Mailing Address - Fax:321-576-2299
Practice Address - Street 1:2194 HWY A1A
Practice Address - Street 2:SUITE 203
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4930
Practice Address - Country:US
Practice Address - Phone:321-576-2299
Practice Address - Fax:321-576-2299
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health