| Doctor Name: | MS. ANDREA TERRY |
| NPI Number: | 1750347951 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC |
| License Number: | 0086301 |
| Business Practice Address: | 6 Sacred Vista El Prado, NM - 87529 |
| Business Phone Number: | 5756133221 |
| Business Fax Number: | |
| Mailing Address: | Po Box 241, EL PRADO |
| State: | NM |
| Postal Code: | 87529 |
| Phone Number: | 5056133221 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2006 |
| NPI Last Update Date: | 08/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0086301 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |