Individual
COREY MARTEZ TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC, MHSP, NCC
Contact information
Practice address
855 W COLLEGE ST, SUITE H, MURFREESBORO, TN 37129-2762
(615) 809-5995
Mailing address
3340 BLAZE DR, MURFREESBORO, TN 37128-3878
(615) 890-5995
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2170
TN
101YP2500X
Professional Counselor
2170
TN
Other
Enumeration date
09/25/2006
Last updated
06/13/2011
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