Provider Information for 1578065330
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TERRI O'GEARY TODD LMHC
Sex: Female
NPI: 1578065330
Last Updated: 2019-07-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1578065330 | ||||||||
| Enumeration Date | 2018-03-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 103A LEWIS ST FORT WALTON BEACH, FL 32547-3142 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 103A LEWIS ST FORT WALTON BEACH, FL 32547-3142 United States Phone: 850-803-7377 | Fax: | ||||||||
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