Provider Demographics
NPI:1932688538
Name:TORRENCE, COLLEEN ANN (MED, LBS)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ANN
Last Name:TORRENCE
Suffix:
Gender:F
Credentials:MED, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 RISING SUN RD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-1822
Mailing Address - Country:US
Mailing Address - Phone:610-761-6178
Mailing Address - Fax:
Practice Address - Street 1:121 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3516
Practice Address - Country:US
Practice Address - Phone:610-687-2488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health