Provider Demographics
NPI:1275692071
Name:TERRY, CAROL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:TERRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1006 24TH AVE NW STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6344
Mailing Address - Country:US
Mailing Address - Phone:405-321-0303
Mailing Address - Fax:405-801-2846
Practice Address - Street 1:1006 24TH AVE NW STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6344
Practice Address - Country:US
Practice Address - Phone:405-321-0303
Practice Address - Fax:405-801-2846
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK759103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical