| Doctor Name: | TERESA W REDFEARN |
| NPI Number: | 1053674143 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPES, NCSP |
| License Number: | 4605 |
| Business Practice Address: | 718 S 4th St Hartsville, SC - 295505724 |
| Business Phone Number: | 8439170495 |
| Business Fax Number: | 8647514179 |
| Mailing Address: | 718 S 4th St, Po Box 1257 HARTSVILLE |
| State: | SC |
| Postal Code: | 295505724 |
| Phone Number: | 8439170495 |
| Fax Number: | 8647514179 |
| NPI Enumeration Date: | 06/22/2012 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TM1800X |
| License Number: | 4605 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Mental Retardation & Developmental Disabilities |
| Taxonomy Definition: | |