Healthcare Provider Details

I. General information

NPI: 1831942408
Provider Name (Legal Business Name): TESSA SEKULA MFTC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 QUEBEC ST STE 7600
DENVER CO
80207-2345
US

IV. Provider business mailing address

13181 E 110TH PL
COMMERCE CITY CO
80022-6262
US

V. Phone/Fax

Practice location:
  • Phone: 720-663-9587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0014389
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: