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NPI Code Detail

MEDICARE: TERESITA MARIE TIRONA MA, LPC

MEDICARE:   TERESITA MARIE TIRONA  MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4450CO

General Provider Information

NPI Number : 1851518377
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESITA MARIE TIRONA MA, LPC
Provider Business Mailing Address
First Line : PO BOX 7071
Second Line :
City : WOODLAND PARK
State : CO
Zip : 80863-0071
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10 FARRAGUT AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5626
Country : US
Telephone Number : 719-761-1655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/08/2007

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Directions to “ TERESITA MARIE TIRONA MA, LPC” Practice Location

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