MEDICARE: JENNIFER TEUBL M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1801251798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER TEUBL M.S.

Provider Business Mailing Address
First Line	:	1936 N DRUID HILLS RD NE
Second Line	:	STE A
City	:	ATLANTA
State	:	GA
Zip	:	30319-4131
Country	:	US
Telephone Number	:	470-488-8423
Fax Number	:

Provider Business Practice Location Address
First Line	:	1936 N DRUID HILLS RD NE
Second Line	:	STE A
City	:	ATLANTA
State	:	GA
Zip	:	30319-4131
Country	:	US
Telephone Number	:	470-488-8423
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2015
Last Update Date	:	05/14/2019

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