Provider Demographics
NPI:1689307324
Name:DEANS, TERRY
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:DEANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 JUMPING FROG LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7356
Mailing Address - Country:US
Mailing Address - Phone:919-757-9297
Mailing Address - Fax:
Practice Address - Street 1:504 JUMPING FROG LN
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7356
Practice Address - Country:US
Practice Address - Phone:919-757-9297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician