| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ZACH TEAGUE | 1003415480 | 2020-10-18 |
Zach Teague is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1003415480. Registration indicates Zach Teague is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Zach Teague |
| Practice Office Address | 2248 NW 164TH ST EDMOND, OK US |
| Practice Office Telephone | 4056052663 |
| Practice Office Fax | 4055623753 |
| Mailing Address | 3517 NW 164TH TER EDMOND, OK 730139471 US |
| Business Telephone | 4056052663 |
| Business Fax | 4055623753 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |