Provider Demographics
NPI:1902816036
Name:CHADWICK, TERRI SKINNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:SKINNER
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:SKINNER
Other - Last Name:BOBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:219 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3955
Mailing Address - Country:US
Mailing Address - Phone:210-333-4755
Mailing Address - Fax:210-333-1833
Practice Address - Street 1:2611 EISENHAUER RD APT 1007
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3470
Practice Address - Country:US
Practice Address - Phone:210-332-0032
Practice Address - Fax:210-333-1833
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24915103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038760708Medicaid
TX123942805Medicaid
TX680006514OtherRAILROAD