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General NPI Number Information
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NPI Number | 1275957664
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Entity Type | Individual
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Provider Name | TERRI T MCCLERKLIN
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Gender | Female
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 441 N MAIN ST
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City | SUMTER
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State | SC
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Zip | 29150-4232
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Country | US
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Telephone | 803-775-5080
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Fax | 803-773-6256
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Provider Business Mailing Address
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Address Line | 438 REGENCY PARK DR
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City | COLUMBIA
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State | SC
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Zip | 29210-4064
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Country | US
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Telephone | 803-422-1577
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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