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General NPI Number Information
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NPI Number | 1396450623
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Entity Type | Individual
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Provider Name | TEALE JANYSEK LPC
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Gender | Female
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 4220 MONTEREY OAKS BLVD
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City | AUSTIN
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State | TX
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Zip | 78749-1170
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Country | US
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Telephone | 918-605-3909
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Fax |
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Provider Business Mailing Address
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Address Line | 948 LONG CREEK BLVD
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-8298
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Country | US
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Telephone | 918-605-3909
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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 | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number | 61750
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71001
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License Number State | TX
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