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General NPI Number Information
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NPI Number | 1730896036
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Entity Type | Individual
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Provider Name | TERRI LYNN PROCTOR MS, LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 304 W BROAD ST
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City | DUNN
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State | NC
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Zip | 28334-4806
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Country | US
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Telephone | 910-808-1733
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Fax |
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Provider Business Mailing Address
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Address Line | 307 W PARRISH DR
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City | BENSON
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State | NC
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Zip | 27504-1649
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Country | US
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Telephone | 615-424-6094
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A18098
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License Number State | NC
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