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General NPI Number Information
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NPI Number | 1265415731
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Entity Type | Individual
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Provider Name | JOHN CARR TERRY MS
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Gender | Male
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2869 SENECA TRL S
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City | PETERSTOWN
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State | WV
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Zip | 24963-5037
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Country | US
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Telephone | 304-431-3010
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Fax | 304-431-3011
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Provider Business Mailing Address
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Address Line | PO BOX 590
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City | UNION
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State | WV
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Zip | 24983-0590
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Country | US
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Telephone | 304-431-3010
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Fax | 304-431-3011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 468
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License Number State | WV
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