Provider Demographics
NPI:1306031166
Name:RICHARDS, TERESA AMANDA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:AMANDA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:A
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:418 PEACEFUL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-8948
Mailing Address - Country:US
Mailing Address - Phone:970-420-2793
Mailing Address - Fax:
Practice Address - Street 1:418 PEACEFUL VALLEY RD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-8948
Practice Address - Country:US
Practice Address - Phone:970-420-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33695103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical