Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013282805 |
---|---|
Provider Name | Dr. Donna Jane Terrell |
First Address | Jbsa Fort Sam Houston, TX 78234 |
Second Address | Jbsa Fort Sam Houston, TX 78234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 16/04/2018 |