Doctor Name: | PRISCILLA UNIS TALLEY |
NPI Number: | 1023207339 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LBSW, LLPC |
License Number: | 6401010391 |
Business Practice Address: | 22140 Dante St Apt 210 Oak Park, MI - 482372840 |
Business Phone Number: | 2485484835 |
Business Fax Number: | |
Mailing Address: | 22140 Dante St, Apt 210 OAK PARK |
State: | MI |
Postal Code: | 48237 |
Phone Number: | 2485484835 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2007 |
NPI Last Update Date: | 10/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401010391 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |