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Individual

MARY TEAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
200 NORTH BROADWAY, EDMOND, OK 73034
(713) 566-0349
Mailing address
PO BOX 5426, EDMOND, OK 73083-5426

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
205033
TX
106H00000X
Marriage & Family Therapist
Primary
2157
OK
106H00000X
Marriage & Family Therapist
35002261A
IN
106H00000X
Marriage & Family Therapist
4101006930
MI

Other

Enumeration date
05/15/2012
Last updated
01/28/2024
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