Provider Demographics
NPI:1700222726
Name:BAHR, TERRY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:A
Last Name:BAHR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4313
Mailing Address - Country:US
Mailing Address - Phone:702-385-3330
Mailing Address - Fax:702-385-5518
Practice Address - Street 1:401 S MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4313
Practice Address - Country:US
Practice Address - Phone:702-385-3330
Practice Address - Fax:702-385-5518
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI0055101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)