Provider Demographics
NPI:1669872263
Name:TERRY, RACHEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 NORTH AVE # 105
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-2601
Mailing Address - Country:US
Mailing Address - Phone:339-234-0295
Mailing Address - Fax:
Practice Address - Street 1:547 NORTH AVE # 105
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-2601
Practice Address - Country:US
Practice Address - Phone:339-234-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023684103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical