Provider Demographics
NPI:1144541251
Name:JENKINS, TERESA L
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:JENKINS
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 1:28 QUAIL RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4262
Mailing Address - Country:US
Mailing Address - Phone:401-615-3395
Mailing Address - Fax:
Practice Address - Street 1:28 QUAIL RIDGE LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4262
Practice Address - Country:US
Practice Address - Phone:401-615-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor