Healthcare Provider Details

I. General information

NPI: 1801709779
Provider Name (Legal Business Name): TERA WORLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2586 JAMES B WHITE HWY N
WHITEVILLE NC
28472-8974
US

IV. Provider business mailing address

3435 OLD CRIBBTOWN RD
CHADBOURN NC
28431-9464
US

V. Phone/Fax

Practice location:
  • Phone: 910-642-5168
  • Fax:
Mailing address:
  • Phone: 910-840-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4681
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: