Provider Demographics
NPI:1730237173
Name:ROSNER-SALAZAR, THERESA (PSYD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:ROSNER-SALAZAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 S WADSWORTH BLVD STE 1-203
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4330
Mailing Address - Country:US
Mailing Address - Phone:720-320-3760
Mailing Address - Fax:303-832-1960
Practice Address - Street 1:777 S WADSWORTH BLVD STE 1-203
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4330
Practice Address - Country:US
Practice Address - Phone:720-320-3760
Practice Address - Fax:303-832-1960
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2730103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical