Provider Demographics
NPI:1780447052
Name:SPELLER- DUNLAP, TERRI
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:SPELLER- DUNLAP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-5422
Mailing Address - Country:US
Mailing Address - Phone:757-952-7264
Mailing Address - Fax:757-244-0999
Practice Address - Street 1:1404 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-5422
Practice Address - Country:US
Practice Address - Phone:757-952-7264
Practice Address - Fax:757-244-0999
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health