Healthcare Provider Details

I. General information

NPI: 1245913656
Provider Name (Legal Business Name): TERRI L CHAMPION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 REECEVILLE RD STE 10
COATESVILLE PA
19320-1532
US

IV. Provider business mailing address

6901 OLD YORK RD APT C309
PHILADELPHIA PA
19126-2237
US

V. Phone/Fax

Practice location:
  • Phone: 856-267-3860
  • Fax:
Mailing address:
  • Phone: 941-725-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: