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General NPI Number Information
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NPI Number | 1427614536
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Entity Type | Individual
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Provider Name | KATIE MARIE TERRY MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 127 CECIL LN # 127
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City | CHATTANOOGA
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State | TN
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Zip | 37412-2211
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Country | US
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Telephone | 405-979-0276
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Fax |
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Provider Business Mailing Address
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Address Line | 12875 WILLOW BAY DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73165-3201
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Country | US
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Telephone | 405-979-0276
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10857
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License Number State | OK
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