Theresa L Clark is a Psychiatry in Dillon, Colorado. Theresa L Clark practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Theresa L Clark is 1104015155. The last update date is 2021-04-14.
Theresa L Clark's current location address is Po Box 2098, Dillon, Colorado. You can contact this provider via phone number 9704559004 and fax number 9495774247. The mailing address for Theresa L Clark is Po Box 2098, Dillon, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Theresa L Clark |
|---|---|
| Address | Po Box 2098, Dillon, Colorado |
| Phone Number | 9704559004 |
| Fax Number | 9495774247 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1104015155 |
|---|---|
| Provider Enumeration Date | 2007-10-16 |
| Last Updated Date | 2021-04-14 |
Provider Mailing Address Detail
| Address | Po Box 2098 |
|---|---|
| City | Dillon |
| State | Colorado (CO) |
| Post Code | 804352098 |
| Phone Number | 9704559004 |
| Fax Number | 9495774247 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 35.135479 |
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Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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What is the unique 10-digit identification code issued to Theresa L Clark by the Centers for Medicare & Medicaid Services?
The Theresa L Clark has been assigned the NPI (National Provider Identifier) 1104015155 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Theresa L Clark?
The Theresa L Clark is situated at Po Box 2098, in the city of Dillon, state of CO, with the zip code 804352098.
What is Theresa L Clark's specialized field of practice, and what is the corresponding taxonomy classification code?
The Theresa L Clark's area of specialization is Psychiatry, and the corresponding taxonomy code that categorizes this field of practice is 2084P0800X.
When was the Theresa L Clark's 1104015155 issued?
The Theresa L Clark's 1104015155 was issued on 2007-10-16.
When was the information related to Theresa L Clark most recently updated or refreshed?
The details pertaining to the Theresa L Clark, including its address, specialty, and other relevant information, were last updated or refreshed on 2021-04-14.