Provider Demographics
NPI:1356430219
Name:MULLINAX, TERESA H (LPC)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:H
Last Name:MULLINAX
Suffix:
Gender:F
Credentials:LPC
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 1473
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1473
Mailing Address - Country:US
Mailing Address - Phone:256-237-1547
Mailing Address - Fax:256-237-1548
Practice Address - Street 1:115 E 21ST ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-3209
Practice Address - Country:US
Practice Address - Phone:256-237-1547
Practice Address - Fax:256-237-1548
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1786101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor