Provider Demographics
NPI:1821347527
Name:TERRY, GINGER ALLEN (MS, PMFT)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:ALLEN
Last Name:TERRY
Suffix:
Gender:F
Credentials:MS, PMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4382
Mailing Address - Country:US
Mailing Address - Phone:307-265-3977
Mailing Address - Fax:307-265-3008
Practice Address - Street 1:5725 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4382
Practice Address - Country:US
Practice Address - Phone:307-265-3977
Practice Address - Fax:307-265-3008
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY256106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist