Provider Demographics
NPI:1427373091
Name:TEALE, CAMILLE CHERE (NMD)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:CHERE
Last Name:TEALE
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E LEE AVE
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-4214
Mailing Address - Country:US
Mailing Address - Phone:918-224-9700
Mailing Address - Fax:
Practice Address - Street 1:20 E LEE AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4214
Practice Address - Country:US
Practice Address - Phone:918-224-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04-808175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath