| Doctor Name: | TERRY HOLBROOK |
| NPI Number: | 1285056317 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CATC III |
| License Number: | 092114-III |
| Business Practice Address: | 2731 Nugget Ave Lake Isabella, CA - 932409456 |
| Business Phone Number: | 7603793412 |
| Business Fax Number: | |
| Mailing Address: | 29325 Kimberlina Rd., WASCO |
| State: | CA |
| Postal Code: | 93328 |
| Phone Number: | 6617584029 |
| Fax Number: | 6617580891 |
| NPI Enumeration Date: | 01/08/2014 |
| NPI Last Update Date: | 05/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 092114-III |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |