Individual
MRS. TIA KAITLYN TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
102 N OAK ST, HACKETT, AR 72937-4756
(479) 638-7003
Mailing address
1001 HIGHWAY 96 SW, LAVACA, AR 72941-3921
(479) 208-2288
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
201180
AR
235Z00000X
Speech-Language Pathologist
Primary
201525
AR
Other
Enumeration date
08/26/2020
Last updated
07/08/2021
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