Individual
DR. JULIE DAWN TEATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1907 PASS RD, SUITE G, BILOXI, MS 39531-4101
(228) 594-9010
(228) 594-9012
Mailing address
1907 PASS RD, SUITE G, BILOXI, MS 39531-4101
(228) 594-9010
(228) 594-9012
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
39-002
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
562344223
TAX INDENTIFICATION #
MS
Enumeration date
08/16/2006
Last updated
10/26/2010
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