Provider Demographics
NPI:1568004992
Name:FLAHIVE-FORO, TESSA ANNE
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:ANNE
Last Name:FLAHIVE-FORO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:317-343-4860
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:5400 W 11TH ST STE C
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4624
Practice Address - Country:US
Practice Address - Phone:720-571-9562
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-18-33510103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst