Doctor Name: | DR. THERESA ANN LAWSON |
NPI Number: | 1598732364 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1022 |
Business Practice Address: | 2630 Central Ave Life Skills Support Center Eielson Afb, AK - 997022325 |
Business Phone Number: | 9073773071 |
Business Fax Number: | 9073773690 |
Mailing Address: | 2414 Sundog Ct, Apt B EIELSON AFB |
State: | AK |
Postal Code: | 997023102 |
Phone Number: | 9073732188 |
Fax Number: | |
NPI Enumeration Date: | 03/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 1022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |