Provider Demographics
NPI:1811044183
Name:TERLEP, NANCY (MALLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:TERLEP
Suffix:
Gender:F
Credentials:MALLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50486 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2327
Mailing Address - Country:US
Mailing Address - Phone:586-263-2760
Mailing Address - Fax:586-263-2762
Practice Address - Street 1:43411 GARFIELD SUITE A
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-263-2760
Practice Address - Fax:586-263-2762
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist