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General NPI Number Information
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NPI Number | 1144046236
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Entity Type | Individual
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Provider Name | TONI EVANGELINE TEAGUE
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Gender | Female
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Dates
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Enumeration Date | 11/23/2024
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Last Update Date | 11/23/2024
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Provider Practice Location Address
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Address Line | 2333 MORRIS AVE STE C206
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City | UNION
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State | NJ
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Zip | 07083-5739
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Country | US
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Telephone | 908-891-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 24 COOPER DR FL 1
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City | BOONTON
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State | NJ
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Zip | 07005-1212
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Country | US
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Telephone | 973-462-0186
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SCO6359800
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License Number State | NJ
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