Individual
BIANCA NICOLE TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
100 CHAMPIONS PL, EL PASO, TX 79912-3799
(915) 236-2000
Mailing address
100 CHAMPIONS PL, EL PASO, TX 79912-3799
(915) 236-2000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11072010
1
TX
Enumeration date
11/03/2021
Last updated
02/05/2024
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