Individual
LAURIE B TEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
725 JUNIPER SWAMP RD, SHUSHAN, NY 12873-2910
(518) 812-6842
(518) 338-0174
Mailing address
725 JUNIPER SWAMP RD, SHUSHAN, NY 12873-2910
(518) 812-6842
(518) 338-0174
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
101-0131597
VT
Other
Enumeration date
06/21/2017
Last updated
03/10/2022
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