Provider Demographics
NPI:1063638765
Name:STRUTHERS, TERI (MA,NCC, LPCC)
Entity type:Individual
Prefix:MRS
First Name:TERI
Middle Name:
Last Name:STRUTHERS
Suffix:
Gender:F
Credentials:MA,NCC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 261ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:ZIMMERMAN
Mailing Address - State:MN
Mailing Address - Zip Code:55398-4014
Mailing Address - Country:US
Mailing Address - Phone:763-360-2585
Mailing Address - Fax:
Practice Address - Street 1:2061 100TH AVE
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-6119
Practice Address - Country:US
Practice Address - Phone:763-360-2585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00102101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional