Provider Information for 1194018010
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BRANDY LYNN TERRY LPCi
Sex: Female
NPI: 1194018010
Last Updated: 2011-05-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1194018010 | ||||||||
| Enumeration Date | 2011-05-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 8196 N CEDAR SPRINGS RD APT Q7 EAGLE MOUNTAIN, UT 84005-2630 United States Phone: 801-400-2422 | Fax: | ||||||||
| Primary Practice Address | 560 S STATE ST STE G1 OREM, UT 84058-6397 United States Phone: 801-802-8608 | Fax:801-221-1042 | ||||||||
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