National Provider Identifier

Charles Edward Terry III

Charles Edward Terry III is listed in the NPPES registry with a primary specialty of Behavior Technician in Fairport, NY and a listed phone number of (585) 377-6590.

NPI 1215683313Fairport, NYBehavior Technician

Profile Overview

NPI
1215683313
Provider Type
Individual
Primary Specialty
Behavior Technician
Enumeration Date
February 28, 2022
Last Updated
February 28, 2022

Practice Location

  • 6 N Main St Ste 110
  • Fairport, NY 14450-1581

Phone: (585) 377-6590

Mailing Address

  • 21600 Oxnard St Ste 1800
  • Woodland Hills, CA 91367-7807

Specialties

  • Behavior Technician (106S00000X)
Full Record
NPI
1215683313
Entity Type
Individual
Last Name
Terry
First Name
Charles
Middle Name
Edward
Name Suffix
III
Mailing Street Address
21600 Oxnard St Ste 1800
Mailing City
Woodland Hills
Mailing State
CA
Mailing ZIP Code
91367-7807
Mailing Country
US
Mailing Phone
(818) 345-2346
Practice Street Address
6 N Main St Ste 110
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-1581
Practice Country
US
Practice Phone
(585) 377-6590
Enumeration Date
February 28, 2022
Last Updated
February 28, 2022
Sex
Male
Sole Proprietor
No
Certification Date
February 28, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Behavior Technician (106S00000X)