Provider Demographics
NPI:1174973176
Name:TE, TERRY (M ED CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:TERRY
Middle Name:
Last Name:TE
Suffix:
Gender:F
Credentials:M ED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 PINNACLE XING
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-1062
Mailing Address - Country:US
Mailing Address - Phone:678-964-6814
Mailing Address - Fax:
Practice Address - Street 1:227 PINNACLE XING
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-1062
Practice Address - Country:US
Practice Address - Phone:678-964-6814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24128235Z00000X
NC14584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist