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NPI Code Detail

MEDICARE: DR. TERESA M. NELSEN PH.D.

MEDICARE: DR. TERESA M. NELSEN PH.D.
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
1106H00000XMarriage & Family Therapist286KS
2106H00000XMarriage & Family TherapistMFT.0002530CO

General Provider Information

NPI Number : 1396841359
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERESA M. NELSEN PH.D.
Provider Business Mailing Address
First Line : 5519 HIGH MEADOW DR.
Second Line :
City : MANHATTAN
State : KS
Zip : 66503
Country : US
Telephone Number : 785-317-4780
Fax Number :
Provider Business Practice Location Address
First Line : 12303 AIRPORT WAY STE 125
Second Line :
City : BROOMFIELD
State : CO
Zip : 80021-2729
Country : US
Telephone Number : 970-310-3406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 04/05/2024

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