Provider Demographics
NPI:1952675514
Name:TERRAZAS, KATHERINE (AAS)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:TERRAZAS
Suffix:
Gender:F
Credentials:AAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 30TH CT
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-3344
Mailing Address - Country:US
Mailing Address - Phone:847-406-7050
Mailing Address - Fax:
Practice Address - Street 1:1593 30TH CT
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-3344
Practice Address - Country:US
Practice Address - Phone:847-406-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor