Provider Demographics
NPI:1255474839
Name:TALLEY, STEPHEN SESSIONS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SESSIONS
Last Name:TALLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 995
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0995
Mailing Address - Country:US
Mailing Address - Phone:541-389-2242
Mailing Address - Fax:541-389-5069
Practice Address - Street 1:965 SW EMKAY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3033
Practice Address - Country:US
Practice Address - Phone:541-389-2242
Practice Address - Fax:541-389-5069
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR923103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist