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General NPI Number Information
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NPI Number | 1255790325
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Entity Type | Individual
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Provider Name | DANIELLE TEAGUE-MCDONALD MSW
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Gender | Female
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 5106 E 120TH AVE
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-1462
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Country | US
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Telephone | 813-340-5832
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 NW 29TH MNR
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City | POMPANO BEACH
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State | FL
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Zip | 33069-1031
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Country | US
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Telephone | 813-340-5832
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | FL
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