Individual
TERUCKO TERMAINE COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED. MA. LPC
Contact information
Practice address
2851 S AVENUE B, YUMA, AZ 85364-7726
(928) 580-9711
Mailing address
2851 S AVENUE B, YUMA, AZ 85364-7726
(928) 580-9711
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-18495
AZ
101YP2500X
Professional Counselor
Primary
LPC-18495
AZ
101YP2500X
Professional Counselor
PC-0000719
DE
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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