Provider Demographics
NPI:1831610773
Name:HUNLEY-WOOLWINE, TERI (MS, BCBA, COBA, LBA)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:
Last Name:HUNLEY-WOOLWINE
Suffix:
Gender:F
Credentials:MS, BCBA, COBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3425
Mailing Address - Country:US
Mailing Address - Phone:304-921-0871
Mailing Address - Fax:
Practice Address - Street 1:1315 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3425
Practice Address - Country:US
Practice Address - Phone:304-921-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005489001Medicaid