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Individual

JACQUELYN MICHELLE TEAGUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2535 LONE STAR DR, DALLAS, TX 75212-6313
(830) 355-8331
Mailing address
3651 SANDY BROOK DR UNIT 206, ROUND ROCK, TX 78665-1554

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11979
TX

Other

Enumeration date
06/09/2021
Last updated
06/09/2021
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