Individual
DR. GERALD VANCE TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
851 LINDY LN, HUNTINGTOWN, MD 20639-9591
(410) 257-2851
Mailing address
851 LINDY LN, HUNTINGTOWN, MD 20639-9591
(410) 257-2851
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LCM021
MD
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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