Provider Information for 1154345452
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LISA J TERRY MSW, LCSW
Sex: Female
NPI: 1154345452
Last Updated: 2024-07-23
Certification Date: 2024-07-23
Certification Date: 2024-07-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1154345452 | ||||||||
| Enumeration Date | 2006-07-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 847 20TH PL VERO BEACH, FL 32960-5357 United States Phone: 772-633-6723 | Fax: | ||||||||
| Primary Practice Address | 3150 CARDINAL DR STE 201 VERO BEACH, FL 32963-1931 United States Phone: 772-633-6723 | Fax: | ||||||||
| Secondary Practice Address(es) | 311 BELFAST TER | ||||||||
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