Doctor Name: | NICOLE TERRIEN |
NPI Number: | 1043680424 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2709-226 |
Business Practice Address: | 615 S 8th St Suite 210 Sheboygan, WI - 530814463 |
Business Phone Number: | 9203237431 |
Business Fax Number: | 9203585970 |
Mailing Address: | 615 S 8th St, Suite 210 SHEBOYGAN |
State: | WI |
Postal Code: | 530814463 |
Phone Number: | 9203237431 |
Fax Number: | 9203585970 |
NPI Enumeration Date: | 09/29/2015 |
NPI Last Update Date: | 09/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2709-226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |