Individual
MS. PATCHES DANIELLE TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
295 HOSPITAL ST, MOULTON, AL 35650-1210
(256) 974-6697
Mailing address
1316 SOMERVILLE RD SE, SUITE 1, DECATUR, AL 35601-4305
(256) 260-7361
(256) 341-0747
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51188625
BLUE CROSS BLUE SHIELD
AL
01
—
51188626
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/13/2015
Last updated
04/06/2017
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