Provider Demographics
NPI:1902504491
Name:SIGGERS, TEREZ
Entity Type:Individual
Prefix:MS
First Name:TEREZ
Middle Name:
Last Name:SIGGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TEREZ
Other - Middle Name:
Other - Last Name:SIGGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:1638 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-3240
Mailing Address - Country:US
Mailing Address - Phone:567-661-0565
Mailing Address - Fax:567-661-0567
Practice Address - Street 1:1638 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-3240
Practice Address - Country:US
Practice Address - Phone:567-661-0565
Practice Address - Fax:567-661-0567
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2207783104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker