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Individual

DR. JOHN ELLIS TERRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
334 E COURT AVE, SUITE 3, JEFFERSONVILLE, IN 47130-3412
(502) 609-2089
(812) 280-0222
Mailing address
4860 ROBB ST, SUITE 202, WHEAT RIDGE, CO 80033-2184
(303) 278-7418
(888) 341-5050

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042036A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20042036A
PROFESSIONAL LICENSE
IN
Enumeration date
08/21/2007
Last updated
10/30/2013
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