Provider Demographics
NPI: | 1154031284 |
---|---|
Name: | HENRY, TERRIANN M |
Entity type: | Individual |
Prefix: | MS |
First Name: | TERRIANN |
Middle Name: | M |
Last Name: | HENRY |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 21 KINSMAN VIEW CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | SILVER SPRING |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20901-1649 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 443-741-5029 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 21 KINSMAN VIEW CIR |
Practice Address - Street 2: | |
Practice Address - City: | SILVER SPRING |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20901-1649 |
Practice Address - Country: | US |
Practice Address - Phone: | 443-741-5029 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2022-11-30 |
Last Update Date: | 2022-11-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | 15081 | 101200000X, 102X00000X, 111NR0400X, 1223X0008X, 132700000X, 183500000X, 133N00000X, 171M00000X, 207RH0003X, 207RR0500X, 224ZR0403X, 225200000X, 405300000X, 146L00000X |
MD | 374T00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 146L00000X | Emergency Medical Service Providers | Emergency Medical Technician, Paramedic | |
No | 101200000X | Behavioral Health & Social Service Providers | Drama Therapist | |
No | 102X00000X | Behavioral Health & Social Service Providers | Poetry Therapist | |
No | 111NR0400X | Chiropractic Providers | Chiropractor | Rehabilitation |
No | 1223X0008X | Dental Providers | Dentist | Oral and Maxillofacial Radiology |
No | 132700000X | Dietary & Nutritional Service Providers | Dietary Manager | |
No | 183500000X | Pharmacy Service Providers | Pharmacist | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No | 374T00000X | Nursing Service Related Providers | Religious Nonmedical Nursing Personnel | |
No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No | 224ZR0403X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Driving and Community Mobility |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | |
No | 405300000X | Other Service Providers | Prevention Professional |