| Organization Name: | TERRI SQUIRES, LPC, FNP-C, PNP-C, APRN-RX |
| NPI Number: | 1053779421 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRI LEIGH SQUIRES (CEO) |
| Mailing Address: | 560 Mountain Village Blvd # 102a-b Suite 102a-b Telluride |
| State: | CO US |
| Postal Code: | 814359513 |
| Phone Number: | 8088666533 |
| Fax Number: | 8883387728 |
| NPI Enumeration Date: | 02/01/2016 |
| NPI Last Update Date: | 02/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 5346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |