Provider Demographics
NPI:1740327402
Name:TERHUNE, LAURIE ELLEN (EDD,LP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ELLEN
Last Name:TERHUNE
Suffix:
Gender:F
Credentials:EDD,LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 2ND ST S
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1662
Mailing Address - Country:US
Mailing Address - Phone:320-654-2773
Mailing Address - Fax:320-654-2774
Practice Address - Street 1:110 2ND ST S
Practice Address - Street 2:SUITE 303
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1662
Practice Address - Country:US
Practice Address - Phone:320-654-2773
Practice Address - Fax:320-654-2774
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3578103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling