Healthcare Provider Details
I. General information
NPI: 1154031284
Provider Name (Legal Business Name): MS. TERRIANN M HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21 KINSMAN VIEW CIR
SILVER SPRING MD
20901-1649
US
IV. Provider business mailing address
21 KINSMAN VIEW CIR
SILVER SPRING MD
20901-1649
US
V. Phone/Fax
- Phone: 443-741-5029
- Fax:
- Phone: 443-741-5029
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101200000X |
| Taxonomy | Drama Therapist |
| License Number | 15081 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 102X00000X |
| Taxonomy | Poetry Therapist |
| License Number | 15081 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 15081 |
| License Number State | MD |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223X0008X |
| Taxonomy | Oral and Maxillofacial Radiology Dentistry |
| License Number | 15081 |
| License Number State | MD |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 132700000X |
| Taxonomy | Dietary Manager |
| License Number | 15081 |
| License Number State | MD |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 15081 |
| License Number State | MD |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | 15081 |
| License Number State | MD |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | 15081 |
| License Number State | MD |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 15081 |
| License Number State | MD |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374T00000X |
| Taxonomy | Religious Nonmedical Nursing Personnel |
| License Number | |
| License Number State | MD |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | 15081 |
| License Number State | MD |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224ZR0403X |
| Taxonomy | Driving and Community Mobility Occupational Therapy Assistant |
| License Number | 15081 |
| License Number State | MD |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | 15081 |
| License Number State | MD |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 405300000X |
| Taxonomy | Prevention Professional |
| License Number | 15081 |
| License Number State | MD |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 146L00000X |
| Taxonomy | Paramedic |
| License Number | 15081 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
