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General NPI Number Information
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NPI Number | 1871626986
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Entity Type | Individual
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Provider Name | TERRI IRELAND SOUTHERLAND M.A., L.P.A.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 141 STORAGE RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-8561
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Country | US
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Telephone | 252-443-0318
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Fax |
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Provider Business Mailing Address
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Address Line | 2032 ELDERBERRY CT
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City | NASHVILLE
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State | NC
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Zip | 27856-7876
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Country | US
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Telephone | 252-955-5425
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2253
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License Number State | NC
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