Provider Demographics
NPI:1194843425
Name:TERRY SERVANCE PLLC
Entity Type:Organization
Organization Name:TERRY SERVANCE PLLC
Other - Org Name:PROJECT KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:AZZOUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSOTP
Authorized Official - Phone:281-565-3067
Mailing Address - Street 1:11455 ASHFORD WILLOW
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6169
Mailing Address - Country:US
Mailing Address - Phone:281-565-3067
Mailing Address - Fax:281-565-3067
Practice Address - Street 1:11455 ASHFORD WILLOW
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6169
Practice Address - Country:US
Practice Address - Phone:281-565-3067
Practice Address - Fax:281-565-3067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty