Individual
STEPHANIE TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 LIZZIE ST, SAN LUIS OBISPO, CA 93401-3062
(805) 549-1220
Mailing address
1826 SAN LUIS RANCH RD, SAN LUIS OBISPO, CA 93405-1566
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
13860
CA
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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