| Doctor Name: | MISS TERESA MCCLENDON |
| NPI Number: | 1336291897 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 02-060067 |
| Business Practice Address: | 5321 Spaulding Ct. Riverbank, CA - 953679463 |
| Business Phone Number: | 2098638524 |
| Business Fax Number: | 2095274599 |
| Mailing Address: | 5321 Spaulding Ct., RIVERBANK |
| State: | CA |
| Postal Code: | 953679463 |
| Phone Number: | 2098638524 |
| Fax Number: | 2095274599 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 02-060067 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |