Provider Demographics
NPI:1538959994
Name:DONALD, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DONALD
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 1:1977 DEAN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4587
Mailing Address - Country:US
Mailing Address - Phone:813-360-3831
Mailing Address - Fax:
Practice Address - Street 1:1977 DEAN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4587
Practice Address - Country:US
Practice Address - Phone:813-360-3831
Practice Address - Fax:813-360-3831
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services