Provider Demographics
NPI:1013179340
Name:MCCRARY, TERRI WEIR (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:WEIR
Last Name:MCCRARY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 INSPIRATION DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5435
Mailing Address - Country:US
Mailing Address - Phone:830-832-7286
Mailing Address - Fax:
Practice Address - Street 1:347 INSPIRATION DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5435
Practice Address - Country:US
Practice Address - Phone:830-832-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17613235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1013179340OtherNPPES