Provider Demographics
NPI:1083031538
Name:WRIGHT, TERESA D (MA, NLC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA, NLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10465 MELODY DR STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-4125
Mailing Address - Country:US
Mailing Address - Phone:720-514-9993
Mailing Address - Fax:
Practice Address - Street 1:10465 MELODY DR STE 202
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4125
Practice Address - Country:US
Practice Address - Phone:720-514-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-22
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0103487101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor