| Doctor Name: | TERESA MICHELLE HENLEY |
| NPI Number: | 1467481309 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 4020 |
| Business Practice Address: | Leadville Professional Building 735 Hwy 24 South, Suite B Leadville, CO - 80461 |
| Business Phone Number: | 9703890621 |
| Business Fax Number: | |
| Mailing Address: | 416 E 4th St, LEADVILLE |
| State: | CO |
| Postal Code: | 804613222 |
| Phone Number: | 9703890621 |
| Fax Number: | 7194863292 |
| NPI Enumeration Date: | 07/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |