Doctor Name: | DEBRA TERRY |
NPI Number: | 1073717765 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 074977 |
Business Practice Address: | 260 W Main St Suite 8 Bay Shore, NY - 117068322 |
Business Phone Number: | 6316479009 |
Business Fax Number: | |
Mailing Address: | 23 Elkin Dr, MIDDLE ISLAND |
State: | NY |
Postal Code: | 119532110 |
Phone Number: | 6317756032 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 074977 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |