Provider Demographics
NPI:1467825547
Name:PEWITT, TERISA (MSSW)
Entity type:Individual
Prefix:MRS
First Name:TERISA
Middle Name:
Last Name:PEWITT
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:MS
Other - First Name:TERISA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW
Mailing Address - Street 1:1527 NATHAN CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-5036
Mailing Address - Country:US
Mailing Address - Phone:615-947-6268
Mailing Address - Fax:
Practice Address - Street 1:1527 NATHAN CT
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5036
Practice Address - Country:US
Practice Address - Phone:615-947-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker