Provider Demographics
NPI:1083758973
Name:LAWLER, TERI B
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:B
Last Name:LAWLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MALCOLM FOREST RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8746
Mailing Address - Country:US
Mailing Address - Phone:302-743-5486
Mailing Address - Fax:302-327-4822
Practice Address - Street 1:160 MALCOLM FOREST RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-8746
Practice Address - Country:US
Practice Address - Phone:302-743-5486
Practice Address - Fax:302-327-4822
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2101103TS0200X
DEPC-0000970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool