Doctor Name: | MS. TERESA LYNN JARRELL |
NPI Number: | 1033268818 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 11776 Mariposa Rd Hesperia, CA - 923451637 |
Business Phone Number: | 7609562462 |
Business Fax Number: | 7609567542 |
Mailing Address: | 11776 Mariposa Rd, HESPERIA |
State: | CA |
Postal Code: | 923451622 |
Phone Number: | 7609562462 |
Fax Number: | 7609567542 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |