MEDICARE: ANGELA TEEGARDEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1568884765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA TEEGARDEN

Provider Business Mailing Address
First Line	:	1406 SE 46TH LN
Second Line	:	SUITE 10
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8684
Country	:	US
Telephone Number	:	239-257-1504
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406 SE 46TH LN
Second Line	:	SUITE 10
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8684
Country	:	US
Telephone Number	:	239-257-1504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2014
Last Update Date	:	01/08/2014

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Directions to “ ANGELA TEEGARDEN ” Practice Location

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