| Shelby Teasley | |
|
2405 Westwood Ave Suite J Henrico VA 23230-4017 | |
| (804) 546-1717 | |
| (804) 269-4005 |
| Full Name | Shelby Teasley |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2405 Westwood Ave, Henrico, Virginia |
| Authorized Official Name and Position | Shelby C Teasley (OWNER) |
| Authorized Official Contact | 8045471617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelby Teasley 2405 Westwood Ave Suite J Henrico VA 23230-4017 Ph: (804) 804-5471 | Shelby Teasley 2405 Westwood Ave Suite J Henrico VA 23230-4017 Ph: (804) 546-1717 |
| NPI Number | 1023764529 |
|---|---|
| Provider Enumeration Date | 02/23/2022 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023764529 | NPI | - | NPPES |
| 30017494230001 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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