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Individual

JULIA E TEAGUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3727 ROSE LAKE DR, SUITE 103, CHARLOTTE, NC 28217-2846
(704) 778-7192
Mailing address
3727 ROSE LAKE DR, SUITE 103, CHARLOTTE, NC 28217-2846
(704) 778-7192

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8516
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225X00000X
NC
Enumeration date
01/28/2013
Last updated
01/28/2013
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