Provider Demographics
NPI:1992583892
Name:APPLEWHITE, TEONAH
Entity type:Individual
Prefix:
First Name:TEONAH
Middle Name:
Last Name:APPLEWHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 SCHOLAR DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6781
Mailing Address - Country:US
Mailing Address - Phone:919-656-3791
Mailing Address - Fax:
Practice Address - Street 1:109 S ELM ST
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-9181
Practice Address - Country:US
Practice Address - Phone:919-656-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness