Provider Demographics
NPI:1487058772
Name:WHITEHEAD, TERRI
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 HALLMARK CT
Mailing Address - Street 2:3190 HALLMARK CT
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2100
Mailing Address - Country:US
Mailing Address - Phone:989-790-3366
Mailing Address - Fax:989-790-5027
Practice Address - Street 1:6840 MIDLAND RD.
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MI
Practice Address - Zip Code:48623-8700
Practice Address - Country:US
Practice Address - Phone:989-692-2160
Practice Address - Fax:989-692-2165
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor