Individual
MRS. KATHILYN N TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL, CHT
Contact information
Practice address
639 S WALKER ST STE E, BLOOMINGTON, IN 47403-2124
(812) 333-4000
(812) 333-0611
Mailing address
201 PENNSYLVANIA PKWY STE 100, INDIANAPOLIS, IN 46280-1393
(317) 817-1200
(317) 817-1220
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31004771A
IN
225XH1200X
Hand Occupational Therapist
Primary
31004771A
IN
Other
Enumeration date
07/03/2007
Last updated
09/10/2018
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