Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | LPC4712 | GA |
N | 102L00000X | Psychologist | PSY2456 | GA |
N | 103T00000X | Psychologist | PSY2456 | GA |
Y | 103TC1900X | Counseling Psychologist | 2102 | AL |
NPI | 1023246188 |
---|---|
Provider Name | Deanne J Terrell |
First Address | Montgomery, AL 36112 |
Second Address | Montgomery, AL 36112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 19/03/2019 |