Individual
ALLEN L TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
Mailing address
5355 RED BLUFF RD, LORIS, SC 29569-6315
(843) 997-8350
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3657
SC
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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