Provider Demographics
NPI:1982196259
Name:UTTER, TERRA
Entity Type:Individual
Prefix:
First Name:TERRA
Middle Name:
Last Name:UTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14048 OLD HAMPSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-6539
Mailing Address - Country:US
Mailing Address - Phone:804-256-1100
Mailing Address - Fax:
Practice Address - Street 1:14048 OLD HAMPSTEAD CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-6539
Practice Address - Country:US
Practice Address - Phone:804-256-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-03
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty