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NPI Code Detail

MEDICARE: DR. THOMAS L TERRACIANO PHD

MEDICARE:  DR. THOMAS L TERRACIANO  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist0810001412VA

General Provider Information

NPI Number : 1386756526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS L TERRACIANO PHD
Provider Business Mailing Address
First Line : 3932 SPRINGFIELD ROAD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-4119
Country : US
Telephone Number : 804-747-8300
Fax Number : 804-747-6215
Provider Business Practice Location Address
First Line : 3932 SPRINGFIELD ROAD
Second Line : WEST END FAMILY COUNSELING
City : GLEN ALLEN
State : VA
Zip : 23060-4119
Country : US
Telephone Number : 804-747-8300
Fax Number : 804-747-6215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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