Individual
TERRICEA JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20410 OBSERVATION DR STE 108, GERMANTOWN, MD 20876-6419
(240) 296-5645
Mailing address
20410 OBSERVATION DR STE 108, GERMANTOWN, MD 20876-6419
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327612TD1
—
MD
Enumeration date
09/16/2019
Last updated
09/16/2019
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