Provider Demographics
NPI:1720552854
Name:TERREROS, ANGELA WILSON (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:WILSON
Last Name:TERREROS
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1706
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33871-1706
Mailing Address - Country:US
Mailing Address - Phone:863-451-8448
Mailing Address - Fax:
Practice Address - Street 1:6723 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33876-5737
Practice Address - Country:US
Practice Address - Phone:863-451-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional