Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 611 | WV |
Y | 103TC0700X | Clinical Psychologist | 611 | WV |
NPI | 1003848003 |
---|---|
Provider Name | Terry Laurita Sigley |
First Address | Morgantown, WV 26505-3868 |
Second Address | Morgantown, WV 26505-3868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 18/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001712835 | MTN. STATE (01) | WV |
0164294000 | (05) | WV |