Provider Demographics
NPI:1932430030
Name:TERRELL, DIANA HARDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:HARDER
Last Name:TERRELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1509
Mailing Address - Country:US
Mailing Address - Phone:302-995-9600
Mailing Address - Fax:302-995-9671
Practice Address - Street 1:3608 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1509
Practice Address - Country:US
Practice Address - Phone:302-995-9600
Practice Address - Fax:302-995-9671
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000141103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist