Individual
ANITA ANN TEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 W BLACKWELL ST, TULLAHOMA, TN 37388-3395
(931) 461-0290
Mailing address
344 EMMETT STONE LN, NORMANDY, TN 37360-3133
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
059100301
TN
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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