Provider Demographics
NPI:1366489866
Name:BERNHARDT, TERI MARIE (DIPI AC)
Entity Type:Individual
Prefix:MS
First Name:TERI
Middle Name:MARIE
Last Name:BERNHARDT
Suffix:
Gender:F
Credentials:DIPI AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5438 S XENOPHON WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 W HAMPDEN AVE
Practice Address - Street 2:L 100
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110
Practice Address - Country:US
Practice Address - Phone:720-971-8843
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist