Provider Demographics
NPI:1568722833
Name:OHARA, TERESA L (MS)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:L
Last Name:OHARA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-8120
Mailing Address - Country:US
Mailing Address - Phone:772-489-4726
Mailing Address - Fax:772-489-0423
Practice Address - Street 1:2814 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-8120
Practice Address - Country:US
Practice Address - Phone:772-489-4726
Practice Address - Fax:772-489-0423
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor