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Individual

MRS. MICHELLE T TEAGUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1145 PINEVILLE MATTHEWS RD, MATTHEWS, NC 28105-6518
(704) 849-0686
Mailing address
309 CHARING CROSS DR, MATTHEWS, NC 28105-2618
(704) 651-4281

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0776
NC

Other

Enumeration date
06/08/2022
Last updated
06/08/2022
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