Provider Demographics
NPI:1891933164
Name:ORR, TERRY BONNER (MS)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:BONNER
Last Name:ORR
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:EVALUATION SERVICES
Other - Middle Name:
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA/LPES
Mailing Address - Street 1:236 DANDELION TRL
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4478
Mailing Address - Country:US
Mailing Address - Phone:864-844-9433
Mailing Address - Fax:864-844-9433
Practice Address - Street 1:236 DANDELION TRL
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4478
Practice Address - Country:US
Practice Address - Phone:864-314-4447
Practice Address - Fax:864-844-9433
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3086174400000X
SC1-05-2383103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1306296041OtherTYPE 2 NPI