Provider Demographics
NPI:1164167813
Name:BURGER, TERRY D (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:D
Last Name:BURGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ARBOR PL
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-7292
Mailing Address - Country:US
Mailing Address - Phone:859-298-8955
Mailing Address - Fax:812-725-8559
Practice Address - Street 1:110 E MARKET ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-3410
Practice Address - Country:US
Practice Address - Phone:812-946-6411
Practice Address - Fax:812-725-8559
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1420551103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool