Provider Demographics
NPI:1598213803
Name:SCHALL, TAJAH (MA, R-DMT)
Entity Type:Individual
Prefix:
First Name:TAJAH
Middle Name:
Last Name:SCHALL
Suffix:
Gender:F
Credentials:MA, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2373 CENTRAL PARK BLVD
Mailing Address - Street 2:UNIT 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2300
Mailing Address - Country:US
Mailing Address - Phone:215-605-0280
Mailing Address - Fax:
Practice Address - Street 1:2373 CENTRAL PARK BLVD
Practice Address - Street 2:UNIT 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2300
Practice Address - Country:US
Practice Address - Phone:215-605-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0104925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health