Provider Demographics
NPI:1518487131
Name:TALBERT, LINDA J (BCBA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:TALBERT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-2609
Mailing Address - Country:US
Mailing Address - Phone:203-550-3930
Mailing Address - Fax:203-204-6931
Practice Address - Street 1:161 EAST AVE STE 104
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5710
Practice Address - Country:US
Practice Address - Phone:203-899-0745
Practice Address - Fax:203-204-6931
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-17-26415103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst