Individual
MS. DERONDA VYNETTE TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6005 PARK AVE STE 630B, MEMPHIS, TN 38119-5226
(901) 767-1136
Mailing address
6005 PARK AVE STE 630B, MEMPHIS, TN 38119-5226
(901) 767-1136
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
TN
Other
Enumeration date
10/05/2006
Last updated
09/19/2018
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