Individual
DR. PHILIP B TERRY-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., LCPC
Contact information
Practice address
53 CHAVEZ RD, MORIARTY, NM 87035-5246
(505) 305-0933
Mailing address
PO BOX 1073, MORIARTY, NM 87035-1073
(505) 305-0933
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC1537
MD
Other
Enumeration date
10/13/2020
Last updated
01/12/2024
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