Provider Demographics
NPI:1366617359
Name:FITZGERALD, TERENCE EDWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:EDWARD
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1200 RIDGEFIELD BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2253
Mailing Address - Country:US
Mailing Address - Phone:828-670-7474
Mailing Address - Fax:866-847-7279
Practice Address - Street 1:1200 RIDGEFIELD BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2253
Practice Address - Country:US
Practice Address - Phone:828-670-7474
Practice Address - Fax:866-847-7279
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1793103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical