| Doctor Name: | MR. WALTER DORWIN TEAGUE |
| NPI Number: | 1114029691 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | LC00300739 |
| Business Practice Address: | 10008 Green Forest Dr Adelphi, MD - 207831315 |
| Business Phone Number: | 3014396755 |
| Business Fax Number: | 3014392436 |
| Mailing Address: | 10008 Green Forest Dr, ADELPHI |
| State: | MD |
| Postal Code: | 207831315 |
| Phone Number: | 3014396755 |
| Fax Number: | 3014392436 |
| NPI Enumeration Date: | 09/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC00300739 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |