Provider Demographics
NPI:1972875185
Name:FRANKLIN, TERESA LYNN
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:LYNN
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:LYNN
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED,LPC,NCC
Mailing Address - Street 1:126 WILLOW CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4919
Mailing Address - Country:US
Mailing Address - Phone:817-437-0438
Mailing Address - Fax:
Practice Address - Street 1:777 N WALNUT CREEK DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3221
Practice Address - Country:US
Practice Address - Phone:817-437-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62803101YP2500X
TX258149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional