Individual
MR. WILL JUSTIN TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LLP CAADC
Contact information
Practice address
30375 NORTHWESTERN HWY, STE. 200, FARMINGTON HILLS, MI 48334-3297
(248) 943-0084
Mailing address
23636 MICHIGAN AVE # 547, DEARBORN, MI 48124-1910
(248) 943-0084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013275
MI
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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