Wilson, Terra Renne

Wilson, Terra Renne is an sole proprietor health care provider with primary practice located at 9345 Winchester , Lower Lake CA 95457. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Wilson, Terra Renne can be contacted via phone (707) 995-3235.

Contact Information

Primary practice address
9345 Winchester Lower Lake CA 95457
Phone: (707) 995-3235
Fax: (707) 995-7004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X RI-G0505091545 California

Profile Details

NPI number 1821134271
LBN Legal business name Wilson, Terra Renne
Credentials SAC II
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Aug 21st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821134271 NPPES
California Other RI-G0505091545 SUBSTANCE ABUSE DISORDER

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