Provider Demographics
NPI:1689618688
Name:MAILHOT, TERRIE ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRIE
Middle Name:ANNETTE
Last Name:MAILHOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 LAMBERT LIND HWY
Mailing Address - Street 2:SUITE 120-100
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1131
Mailing Address - Country:US
Mailing Address - Phone:401-681-4274
Mailing Address - Fax:401-681-4285
Practice Address - Street 1:75 LAMBERT LIND HWY
Practice Address - Street 2:QUALITY BEHAVIORAL HEALTH INC
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1131
Practice Address - Country:US
Practice Address - Phone:401-681-4274
Practice Address - Fax:401-681-4285
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD075122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9020062Medicaid
RIRIMD 07512OtherMEDICAL LICENSURE
RI269020062Medicare ID - Type Unspecified
RIRIMD 07512OtherMEDICAL LICENSURE