Provider Demographics
NPI:1790411106
Name:OGDEN, TERRY LEE JR
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LEE
Last Name:OGDEN
Suffix:JR
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 1:1524 PINTO LN
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82007-2907
Mailing Address - Country:US
Mailing Address - Phone:303-241-2338
Mailing Address - Fax:
Practice Address - Street 1:1524 PINTO LN
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82007-2907
Practice Address - Country:US
Practice Address - Phone:303-241-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator