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General NPI Number Information
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NPI Number | 1336339936
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Entity Type | Organization
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Legal Business Name | TERRY F. STULCE
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 2775 EXECUTIVE PARK NW SUITE 1
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City | CLEVELAND
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State | TN
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Zip | 37312-2763
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Country | US
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Telephone | 423-479-9652
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Fax |
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Provider Business Mailing Address
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Address Line | 2775 EXECUTIVE PARK NW SUITE 1
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City | CLEVELAND
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State | TN
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Zip | 37312-2763
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Country | US
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Telephone | 423-479-9652
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. DANA L DILL
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Credential |
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Telephone | 423-479-9652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSW0331
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License Number State | TN
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