Provider Demographics
NPI:1386964591
Name:TERREBONNE, TROY
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:TERREBONNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4940
Mailing Address - Country:US
Mailing Address - Phone:303-432-5824
Mailing Address - Fax:
Practice Address - Street 1:3810 PIERCE ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4940
Practice Address - Country:US
Practice Address - Phone:303-432-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor