Healthcare Provider Details

I. General information

NPI: 1891608600
Provider Name (Legal Business Name): CALEB WAYNE TEETERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 PATTON CREEK DR
HOOVER AL
35226-2251
US

IV. Provider business mailing address

2003 PATTON CREEK DR
HOOVER AL
35226-2251
US

V. Phone/Fax

Practice location:
  • Phone: 205-541-9404
  • Fax:
Mailing address:
  • Phone: 205-541-9404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberNA
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: