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General NPI Number Information
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NPI Number | 1720808959
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Entity Type | Individual
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Provider Name | TERRI S CORDLE LPC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 541 SAND SPRINGS RD NW
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City | ROME
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State | GA
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Zip | 30165-9583
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Country | US
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Telephone | 770-548-9438
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Fax |
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Provider Business Mailing Address
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Address Line | 541 SAND SPRINGS RD NW
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City | ROME
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State | GA
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Zip | 30165-9583
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3441
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License Number State | GA
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