Provider Demographics
NPI:1598947442
Name:TERRELL, JOHN DOUGLAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DOUGLAS
Last Name:TERRELL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CLIFFSIDE CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-1904
Mailing Address - Country:US
Mailing Address - Phone:302-528-6500
Mailing Address - Fax:302-475-0202
Practice Address - Street 1:32 CLIFFSIDE CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-1904
Practice Address - Country:US
Practice Address - Phone:302-528-6500
Practice Address - Fax:302-475-0202
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist