Individual
MR. TERRY LANE THORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA EDS NATIONAL CERT
Contact information
Practice address
RT 10, WYOMING COUNTY SCHOOLS, PINEVILLE, WV 24874
(304) 732-6262
(304) 732-6214
Mailing address
520 MORAN AVE, MULLENS, WV 25882
(304) 294-5446
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
11100
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165555000
—
WV
Enumeration date
01/24/2008
Last updated
01/24/2008
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