Individual
THERESA TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
BALA AVENUE, SUITE 122, BALA CYNWYD, PA 19004
(302) 407-9120
Mailing address
BALA AVENUE, SUITE 122, BALA CYNWYD, PA 19004
(302) 407-9120
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1100916959
PA
376J00000X
Homemaker
1100916959
PA
385H00000X
Respite Care
1100916959
PA
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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