Provider Demographics
NPI:1225641756
Name:NEIMAN, TALIA E
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:E
Last Name:NEIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 N CALIFORNIA AVE APT 4T
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4554
Mailing Address - Country:US
Mailing Address - Phone:818-645-5575
Mailing Address - Fax:
Practice Address - Street 1:6800 N CALIFORNIA AVE APT 4T
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4554
Practice Address - Country:US
Practice Address - Phone:818-645-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health