Individual
DR. JOHN A TEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
633 ASBURY DR, SUITE A, MANDEVILLE, LA 70471-6511
(601) 946-1844
Mailing address
618 EAGLE AVE, JACKSON, MS 39206-5821
(601) 946-1844
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
47818
MS
103TP0016X
Prescribing (Medical) Psychologist
Primary
MP.000036
LA
Other
Enumeration date
02/12/2008
Last updated
06/04/2015
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