Provider Demographics
NPI:1104002955
Name:TALLEY, NANON PATRICE (MC, LPC)
Entity Type:Individual
Prefix:MS
First Name:NANON
Middle Name:PATRICE
Last Name:TALLEY
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16333 HAFER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-4412
Mailing Address - Country:US
Mailing Address - Phone:281-537-0211
Mailing Address - Fax:281-537-0320
Practice Address - Street 1:16333 HAFER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4412
Practice Address - Country:US
Practice Address - Phone:281-537-0211
Practice Address - Fax:281-537-0320
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5747654-6004101Y00000X
TX73353101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor