Individual
DR. TIMOTHY J TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
16159 HAMILTON STATION RD, WATERFORD, VA 20197-1106
(703) 587-7230
Mailing address
16159 HAMILTON STATION RD, WATERFORD, VA 20197-1106
(703) 587-7230
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701001459
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701001459
PROFESSIONAL COUNSELOR
VA
Enumeration date
02/13/2007
Last updated
07/08/2007
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