Provider Demographics
NPI:1790979706
Name:GREGG, TERRI RENEE (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:RENEE
Last Name:GREGG
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E WINDMILL LN # 1B-125
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1869
Mailing Address - Country:US
Mailing Address - Phone:702-281-2552
Mailing Address - Fax:702-361-7743
Practice Address - Street 1:505 E WINDMILL LN # 1B-125
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1869
Practice Address - Country:US
Practice Address - Phone:702-281-2552
Practice Address - Fax:702-361-7743
Is Sole Proprietor?:No
Enumeration Date:2007-09-02
Last Update Date:2007-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV08-0014225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics