| Kristin Teasdale Phd Llc | |
|
1201 Wakarusa Dr E2, Suite 102 Lawrence KS 66049 | |
| (913) 226-5278 | |
| Not Available |
| Full Name | Kristin Teasdale Phd Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1201 Wakarusa Dr, Lawrence, Kansas |
| Authorized Official Name and Position | Kristin Teasdale (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7854343479 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Teasdale Phd Llc 1201 Wakarusa Dr Ste E2 Lawrence KS 66049-1892 Ph: (785) 434-3479 | Kristin Teasdale Phd Llc 1201 Wakarusa Dr E2, Suite 102 Lawrence KS 66049 Ph: (913) 226-5278 |
| NPI Number | 1366932782 |
|---|---|
| Provider Enumeration Date | 05/10/2018 |
| Last Update Date | 01/19/2019 |
| Medicare PECOS PAC ID | 9133474778 |
|---|---|
| Medicare Enrollment ID | O20180621002471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366932782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1939 (Kansas) | Primary |
| Provider Name | Kristin Teasdale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487988333 PECOS PAC ID: 4385774991 Enrollment ID: I20100608000735 |
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