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Individual
TERRELL DONNELL PICKETT
Active
Individual
TERRELL DONNELL PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TE1100X
Exercise & Sports Psychologist
—
—
103TF0000X
Family Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6426468
DCS/OLR
AZ
Enumeration date
08/24/2017
Last updated
02/06/2025
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