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Individual

MRS. THERESA ANN TANKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
36000 DARNALL LOOP, FORT HOOD, TX 76544-5095
(254) 288-3218
(254) 288-3281
Mailing address
36000 DARNALL LOOP, FORT HOOD, TX 76544-5095
(254) 288-3218
(254) 288-3281

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11473
TX
104100000X
Social Worker
8666
TN

Other

Enumeration date
10/01/2012
Last updated
10/01/2012
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