Provider Demographics
NPI:1801251798
Name:TEUBL, JENNIFER (MS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TEUBL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 N DRUID HILLS RD NE
Mailing Address - Street 2:STE A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-4131
Mailing Address - Country:US
Mailing Address - Phone:470-488-8423
Mailing Address - Fax:
Practice Address - Street 1:1936 N DRUID HILLS RD NE
Practice Address - Street 2:STE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-4131
Practice Address - Country:US
Practice Address - Phone:470-488-8423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional