Provider Demographics
NPI:1114501731
Name:PARTEE, TERRENCE ROOSEVELT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:ROOSEVELT
Last Name:PARTEE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 E 12TH AVE UNIT 131
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-3527
Mailing Address - Country:US
Mailing Address - Phone:317-551-3719
Mailing Address - Fax:
Practice Address - Street 1:3700 NW 111TH PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-1480
Practice Address - Country:US
Practice Address - Phone:352-840-7936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11039103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical