Provider Demographics
NPI:1083736607
Name:NADEAU, KATHLEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:NADEAU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:NADEAU
Other - Last Name:TEEGARDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:8607 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4324
Mailing Address - Country:US
Mailing Address - Phone:301-562-8448
Mailing Address - Fax:877-250-1841
Practice Address - Street 1:8607 CEDAR ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4324
Practice Address - Country:US
Practice Address - Phone:301-562-8448
Practice Address - Fax:877-250-1841
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical