Provider Demographics
NPI:1114014404
Name:WOOSLEY, TERRY HENLEY (OTR, MPH)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:HENLEY
Last Name:WOOSLEY
Suffix:
Gender:F
Credentials:OTR, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11449
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-0449
Mailing Address - Country:US
Mailing Address - Phone:334-262-1726
Mailing Address - Fax:
Practice Address - Street 1:1726 W 2ND ST STE C
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1546
Practice Address - Country:US
Practice Address - Phone:334-262-1726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0024225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-74221OtherBLUECROSS-BLUESHIELD/AL