Provider Demographics
NPI:1245368398
Name:MUEGERL, TERRI L (LMSW)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:MUEGERL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E CENTER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6326
Mailing Address - Country:US
Mailing Address - Phone:208-234-2600
Mailing Address - Fax:208-234-2800
Practice Address - Street 1:210 E CENTER ST
Practice Address - Street 2:SUITE B
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6326
Practice Address - Country:US
Practice Address - Phone:208-234-2600
Practice Address - Fax:208-234-2800
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-25007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health