Provider Demographics
NPI:1255364311
Name:LONEY, TERESA E (PSY D)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:E
Last Name:LONEY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 943
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-0943
Mailing Address - Country:US
Mailing Address - Phone:573-964-6010
Mailing Address - Fax:573-964-6909
Practice Address - Street 1:1870 BAGNELL DAM BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-8658
Practice Address - Country:US
Practice Address - Phone:573-964-6010
Practice Address - Fax:573-964-6909
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0393103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist