Provider Demographics
NPI:1205395621
Name:TALYA KNABLE PSYCHOTHERAPY
Entity Type:Organization
Organization Name:TALYA KNABLE PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNABLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:103-954-0854
Mailing Address - Street 1:22 WESTSPRING WAY
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1447
Mailing Address - Country:US
Mailing Address - Phone:973-865-9631
Mailing Address - Fax:
Practice Address - Street 1:1400 FRONT AVE STE 305
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5364
Practice Address - Country:US
Practice Address - Phone:410-395-4085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty