| NPI | 1558961904 |
|---|---|
| Former Name | TERESA LYNN MAYFIELD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |