Doctor Name: | JENNIFER ELIZABETH TALLMAN |
NPI Number: | 1184047649 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ISW8400 |
Business Practice Address: | 1417 Partin Dr N Ste 1 Niceville, FL - 325781426 |
Business Phone Number: | 8507290304 |
Business Fax Number: | 8507290305 |
Mailing Address: | 1417 Partin Dr N Ste 1, NICEVILLE |
State: | FL |
Postal Code: | 325781426 |
Phone Number: | 8507290304 |
Fax Number: | 8507290305 |
NPI Enumeration Date: | 02/03/2014 |
NPI Last Update Date: | 02/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | ISW8400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |