Organization
TEAGUE PSYCHOLOGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES BRADLEY TEAGUE PHD (PRESIDENT)
(317) 849-9509
Entity
Organization
Contact information
Practice address
6470 N. SHADELAND, SUITE C, INDIANAPOLIS, IN 46220
(317) 849-9509
(317) 841-1157
Mailing address
6470 N. SHADELAND, SUITE C, INDIANAPOLIS, IN 46220
(317) 849-9509
(317) 841-1157
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
20040735
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100216740
—
IN
Enumeration date
01/11/2012
Last updated
01/11/2012
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