Provider Demographics
NPI:1013071190
Name:LLOYD, TERESA MILLER
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:MILLER
Last Name:LLOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TERI
Other - Middle Name:ANN
Other - Last Name:LLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1810 LAUDERDALE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1624
Mailing Address - Country:US
Mailing Address - Phone:502-905-9494
Mailing Address - Fax:
Practice Address - Street 1:1729 HIGHWAY 44 E
Practice Address - Street 2:A
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7146
Practice Address - Country:US
Practice Address - Phone:502-543-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist