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General NPI Number Information
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NPI Number | 1013709930
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Entity Type | Individual
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Provider Name | JAMES MATTHEW TEAGUE
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Gender | Male
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 5120 VIRGINIA WAY STE C-12
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City | BRENTWOOD
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State | TN
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Zip | 37027-7515
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Country | US
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Telephone | 615-200-0387
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 WHITES CREEK PIKE
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City | WHITES CREEK
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State | TN
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Zip | 37189-9133
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Country | US
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Telephone | 615-939-2433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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