Individual
MRS. TERRIE ANN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1120 S CHESLEY DR, LOUISVILLE, KY 40219-4904
(502) 773-5459
Mailing address
1120 S CHESLEY DR, LOUISVILLE, KY 40219-4904
(502) 773-5459
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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