Provider Demographics
NPI:1912910605
Name:CARLSON, TERI L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:L
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4440 ARAPAHOE AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-9100
Mailing Address - Country:US
Mailing Address - Phone:303-395-4727
Mailing Address - Fax:720-328-5596
Practice Address - Street 1:4440 ARAPAHOE AVE STE 220
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-9100
Practice Address - Country:US
Practice Address - Phone:303-395-4727
Practice Address - Fax:720-328-5596
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2022-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA854422084P0800X
CO523022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry