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NPI Code Detail

MEDICARE: SANDRA TESKE

MEDICARE:   SANDRA  TESKE
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
1101YM0800XMental Health Counselor
2101Y00000XCounselor
3101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1770299828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA TESKE
Provider Business Mailing Address
First Line : PO BOX 32
Second Line :
City : MASONVILLE
State : CO
Zip : 80541-0032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1220 S COLLEGE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3785
Country : US
Telephone Number : 970-829-8823
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2023
Last Update Date : 01/23/2023

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Directions to “ SANDRA TESKE ” Practice Location

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