Individual
DR. THERESA L CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
114 VILLAGE PLACE, ST 207, DILLON, CO 80435
(970) 455-9004
(949) 577-4247
Mailing address
PO BOX 2098, DILLON, CO 80435-2098
(970) 455-9004
(949) 577-4247
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35.135479
OH
2084P0800X
Psychiatry Physician
Primary
DR.0061413
CO
2084P0800X
Psychiatry Physician
ME104695
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN11797
FL
Other
Enumeration date
10/16/2007
Last updated
05/17/2025
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