MEDICARE: TERRI JO ALFORD

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
1	101YP2500X	Professional Counselor	CI0106	NV

General Provider Information

NPI Number	:	1578843413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI JO ALFORD

Provider Business Mailing Address
First Line	:	6284 S RAINBOW BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3245
Country	:	US
Telephone Number	:	916-730-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	6284 S RAINBOW BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3245
Country	:	US
Telephone Number	:	916-730-0307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	06/26/2022

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Directions to “ TERRI JO ALFORD ” Practice Location

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