Provider Demographics
NPI:1548048317
Name:DOLLAR, TERESA JANE
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:JANE
Last Name:DOLLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:JANE
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1540 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-5095
Mailing Address - Country:US
Mailing Address - Phone:501-753-5459
Mailing Address - Fax:501-850-8791
Practice Address - Street 1:1540 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-5095
Practice Address - Country:US
Practice Address - Phone:501-753-5459
Practice Address - Fax:501-850-8791
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR106S00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No174400000XOther Service ProvidersSpecialist