Provider Demographics
NPI:1386857936
Name:WELLS, TERRY J (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:J
Last Name:WELLS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:TERRY
Other - Middle Name:J
Other - Last Name:MOLZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:445 DROOPING LEAF RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-6626
Mailing Address - Country:US
Mailing Address - Phone:201-306-7041
Mailing Address - Fax:
Practice Address - Street 1:3525 AUGUSTUS RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-2701
Practice Address - Country:US
Practice Address - Phone:803-642-8376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00185400235Z00000X
SC6035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist