Provider Demographics
NPI:1376080762
Name:SCOTT, TERRY (NCCPSS, LIFE COACH)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:NCCPSS, LIFE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S BULLOCK ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5185
Mailing Address - Country:US
Mailing Address - Phone:252-767-5700
Mailing Address - Fax:252-572-2160
Practice Address - Street 1:141 S BULLOCK ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5185
Practice Address - Country:US
Practice Address - Phone:252-767-5700
Practice Address - Fax:252-572-2160
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor