Individual
TERRI MARIE CLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1 WASHINGTON MALL STE 1045, BOSTON, MA 02108-2603
(617) 249-4036
(617) 843-9320
Mailing address
1 WASHINGTON MALL STE 1045, BOSTON, MA 02108-2603
(617) 249-4036
(617) 843-9320
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN214255
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2362195
MA
363LP2300X
Primary Care Nurse Practitioner
RN214255
GA
Other
Enumeration date
12/05/2017
Last updated
04/29/2025
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