| Doctor Name: | PATRICIA MARY TEGELER |
| NPI Number: | 1063529477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | LCSW 1028 |
| Business Practice Address: | 806 S Otsego Ave Va Cboc Gaylord, MI - 497351725 |
| Business Phone Number: | 9897327525 |
| Business Fax Number: | 9897326577 |
| Mailing Address: | Va Cboc, 806 S. Otsego Ave. GAYLORD |
| State: | MI |
| Postal Code: | 49735 |
| Phone Number: | 9897327525 |
| Fax Number: | 9897326577 |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW 1028 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |