Doctor Name: | TEISHA KAY CALDWELL |
NPI Number: | 1023252467 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | 0153601 |
Business Practice Address: | 1505 15th St Los Alamos, NM - 875443000 |
Business Phone Number: | 5059302139 |
Business Fax Number: | |
Mailing Address: | 1500 Escondida Ct, SANTA FE |
State: | NM |
Postal Code: | 875075124 |
Phone Number: | 5059302139 |
Fax Number: | |
NPI Enumeration Date: | 04/29/2009 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0153601 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |