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General NPI Number Information
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NPI Number | 1811679723
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Entity Type | Individual
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Provider Name | TERESA M ORNELAS LSW
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Gender | Female
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 421 S TEJON ST STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2139
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Country | US
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Telephone | 719-424-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 4164 AUSTIN BLUFFS PKWY # 112
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-2928
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Country | US
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Telephone | 719-287-6828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009924194
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License Number State | CO
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