Provider Demographics
NPI:1699070078
Name:TUONO-SHELL, TERRA (LCPC)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:TUONO-SHELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MING AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4689
Mailing Address - Country:US
Mailing Address - Phone:240-274-7496
Mailing Address - Fax:
Practice Address - Street 1:7945 MACARTHUR BLVD STE 214
Practice Address - Street 2:
Practice Address - City:CABIN JOHN
Practice Address - State:MD
Practice Address - Zip Code:20818-1634
Practice Address - Country:US
Practice Address - Phone:240-274-7496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3111101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional