Individual
TERESA W REDFEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPES, NCSP
Contact information
Practice address
122 E HOME AVE, HARTSVILLE, SC 29550-3712
(843) 917-0495
(864) 751-4179
Mailing address
PO BOX 1257, HARTSVILLE, SC 29551-1257
(843) 917-0495
(864) 751-4179
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4605
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
4605
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45-5198811
EPI
SC
05
—
4605
—
SC
05
—
LP1000
—
SC
Enumeration date
06/22/2012
Last updated
04/24/2025
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