Provider Demographics
NPI:1821427295
Name:TEEHEE, BRENDA JOE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JOE
Last Name:TEEHEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25719 S PIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-1473
Mailing Address - Country:US
Mailing Address - Phone:918-822-0076
Mailing Address - Fax:
Practice Address - Street 1:25719 S PIN OAK DR
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-1473
Practice Address - Country:US
Practice Address - Phone:918-822-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health