Healthcare Provider Details

I. General information

NPI: 1609226893
Provider Name (Legal Business Name): THERESA RICE MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERRI RICE MA AMFT

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2292 DALTON DR STE C
CLARKSVILLE TN
37043-8961
US

IV. Provider business mailing address

1004 FOXMOOR DR
CLARKSVILLE TN
37042-5463
US

V. Phone/Fax

Practice location:
  • Phone: 931-494-6803
  • Fax:
Mailing address:
  • Phone: 541-324-1838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2830
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: