Individual
TERESA A POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
692 N SPENCE AVE, SUITE B, GOLDSBORO, NC 27534-4339
(919) 778-8757
(919) 778-8758
Mailing address
692 N SPENCE AVE, SUITE B, GOLDSBORO, NC 27534-4339
(919) 778-8757
(919) 778-8758
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1791
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0473E
BLUE CROSS BLUE SHIELD
NC
05
—
6000096
—
NC
01
—
E1424
MEDCOST
NC
Enumeration date
02/03/2006
Last updated
07/09/2007
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