Provider Demographics
NPI:1568816841
Name:TELKAMP, TERREEA (MA)
Entity Type:Individual
Prefix:
First Name:TERREEA
Middle Name:
Last Name:TELKAMP
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:TERREEA
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:5200 KARLUK STREET
Mailing Address - City:BARROW
Mailing Address - State:AK
Mailing Address - Zip Code:99723-0069
Mailing Address - Country:US
Mailing Address - Phone:907-852-0366
Mailing Address - Fax:907-852-0268
Practice Address - Street 1:5200 KARLUK STREET
Practice Address - Street 2:NUMBER 69
Practice Address - City:BARROW
Practice Address - State:AK
Practice Address - Zip Code:99723
Practice Address - Country:US
Practice Address - Phone:907-852-0366
Practice Address - Fax:907-852-0268
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker