Doctor Name: | WANDA SUE TEAT |
NPI Number: | 1982075214 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH12834 |
Business Practice Address: | 1581 Highway 98 E. Ste C Carrabelle, FL - 323222208 |
Business Phone Number: | 8506535014 |
Business Fax Number: | |
Mailing Address: | Po Box 532, APALACHICOLA |
State: | FL |
Postal Code: | 323290532 |
Phone Number: | 8506538383 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2015 |
NPI Last Update Date: | 10/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH12834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |