Provider Demographics
NPI:1902090491
Name:LA NOTTE, TERRY JEAN (MFT)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:JEAN
Last Name:LA NOTTE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 N MILLBROOK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3363
Mailing Address - Country:US
Mailing Address - Phone:559-229-2273
Mailing Address - Fax:559-432-4051
Practice Address - Street 1:7171 N MILLBROOK AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3363
Practice Address - Country:US
Practice Address - Phone:559-229-2273
Practice Address - Fax:559-432-4051
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34500106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist