Provider Demographics
NPI:1326814088
Name:THURMAN, TERRENCE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:
Last Name:THURMAN
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 10TH ST S APT 1306
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-5430
Mailing Address - Country:US
Mailing Address - Phone:404-660-7910
Mailing Address - Fax:
Practice Address - Street 1:184 HIGH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-3001
Practice Address - Country:US
Practice Address - Phone:866-600-7598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP200001545235Z00000X
VA2202011203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist