Individual
DR. TERRY ISAACSON
Active
Individual
DR. TERRY ISAACSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0814
OR
103TC0700X
Clinical Psychologist
Primary
0814
OR
103TC1900X
Counseling Psychologist
0814
OR
103TR0400X
Rehabilitation Psychologist
0814
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
803779000
REGENCE BCBSO PROV NO
OR
Enumeration date
11/03/2005
Last updated
06/16/2010
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