Provider Demographics
NPI:1083075873
Name:KEY, TERRANCE MILES
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:MILES
Last Name:KEY
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 1:2120 OLD STERLINGTON
Mailing Address - Street 2:UNIT 22
Mailing Address - City:STERLINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:71280
Mailing Address - Country:US
Mailing Address - Phone:318-680-7792
Mailing Address - Fax:
Practice Address - Street 1:506 HWY 2
Practice Address - Street 2:
Practice Address - City:STERLINGTON
Practice Address - State:LA
Practice Address - Zip Code:71280
Practice Address - Country:US
Practice Address - Phone:318-598-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health