Healthcare Provider Details

I. General information

NPI: 1174669089
Provider Name (Legal Business Name): TERI UHLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

IV. Provider business mailing address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

V. Phone/Fax

Practice location:
  • Phone: 334-953-3368
  • Fax:
Mailing address:
  • Phone: 334-953-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2095C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: