Provider Demographics
NPI:1053513101
Name:BREON, TERRI L (MS, LPC)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:BREON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22B NORTHEAST DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2732
Mailing Address - Country:US
Mailing Address - Phone:717-531-6067
Mailing Address - Fax:717-531-6250
Practice Address - Street 1:22B NORTHEAST DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2732
Practice Address - Country:US
Practice Address - Phone:717-531-6067
Practice Address - Fax:717-531-6250
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPC000884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor