Provider Demographics
NPI:1609313709
Name:HAMM, TALIA
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:HAMM
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 1:3865 DOREEN CT
Mailing Address - Street 2:APT 2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-1499
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:305 W MOANA LN
Practice Address - Street 2:D 1
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4984
Practice Address - Country:US
Practice Address - Phone:775-337-9359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health