Provider Demographics
NPI:1932357175
Name:WREN, TERESA ELAINE (LMSW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ELAINE
Last Name:WREN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8889 FOX DR STE B
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-8842
Mailing Address - Country:US
Mailing Address - Phone:479-372-1077
Mailing Address - Fax:
Practice Address - Street 1:1988 E 100TH PL
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-3962
Practice Address - Country:US
Practice Address - Phone:479-372-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2148M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker