Individual
TERESA MICHELLE HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
LEADVILLE PROFESSIONAL BUILDING, 735 HWY 24 SOUTH, SUITE B, LEADVILLE, CO 80461
(970) 389-0621
Mailing address
PO BOX 1989, LEADVILLE, CO 80461-1989
(970) 389-0621
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4020
CO
103T00000X
Psychologist
3965
CO
103TC0700X
Clinical Psychologist
Primary
PSY.0003956
CO
Other
Enumeration date
07/02/2006
Last updated
05/14/2024
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