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General NPI Number Information
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NPI Number | 1205137072
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Entity Type | Individual
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Provider Name | MITCHELL WILLIAM TEUFEL MA ABS
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Gender | Male
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 11521 NE 21ST ST
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City | BELLEVUE
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State | WA
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Zip | 98004-3026
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Country | US
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Telephone | 206-325-6296
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Fax |
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Provider Business Mailing Address
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Address Line | 11410 NE 124TH ST # 410
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City | KIRKLAND
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State | WA
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Zip | 98034-4305
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Country | US
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Telephone | 206-325-6296
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | MC60152504
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License Number State | WA
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