Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. THERESA L CLARK, M.D.
Active Sole ProprietorDR. THERESA L CLARK, M.D. is a Psychiatry healthcare provider located in DILLON, Colorado. NPI 1104015155 is currently active in the NPPES registry. Verify at CMS.
Psychiatry · DILLON, CO
Registration Details
- NPI Number
- 1104015155
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 16, 2007 (18.872270587977 yrs)
- Last Updated
- May 17, 2025
- Licenses
-
35.135479 (OH)ME104695 (FL)TRN11797 (FL)DR.0061413 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
114 VILLAGE PLACEST 207DILLON, CO, 80435Browse CO providers · Browse ZIP 80435
- Phone
- 9704559004
- Fax
- 9495774247
- Primary Specialty
-
Psychiatry
2084P0800X
- Additional Specialty
- Psychiatry
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.