Provider Demographics
NPI:1508227026
Name:TALLARD, MARIE S (CBIS, CRT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:S
Last Name:TALLARD
Suffix:
Gender:F
Credentials:CBIS, CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:SUITE 4D
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-262-7800
Mailing Address - Fax:732-262-7808
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:SUITE 4D
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-262-7800
Practice Address - Fax:732-262-7808
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No171W00000XOther Service ProvidersContractor
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No253Z00000XAgenciesIn Home Supportive Care