Provider Demographics
NPI:1073943221
Name:CALDWELL, TEASHANIQUE SHEIR
Entity Type:Individual
Prefix:
First Name:TEASHANIQUE
Middle Name:SHEIR
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 ORCHARD VALLEY DR
Mailing Address - Street 2:APT# 2071
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-0704
Mailing Address - Country:US
Mailing Address - Phone:702-981-1085
Mailing Address - Fax:
Practice Address - Street 1:1572 ORCHARD VALLEY DR
Practice Address - Street 2:APT# 2071
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-0704
Practice Address - Country:US
Practice Address - Phone:702-981-1085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-24
Last Update Date:2013-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1403478960103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst