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General NPI Number Information
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NPI Number | 1164690186
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Entity Type | Organization
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Legal Business Name | TERESA J MARSHALL PSYCHOLOGIAL SERVICES, LLC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 2860 S CIRCLE DR STE 250L
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4132
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Country | US
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Telephone | 719-406-1223
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Fax | 719-465-1394
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Provider Business Mailing Address
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Address Line | 2860 S CIRCLE DR. STE 250L
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4132
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Country | US
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Telephone | 719-406-1223
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Fax | 719-465-1394
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. TERESA J MARSHALL
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Credential | PH.D
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Telephone | 719-406-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1394
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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