Provider Demographics
NPI:1609344183
Name:BRANCH, TALAISHA (LCSW)
Entity Type:Individual
Prefix:
First Name:TALAISHA
Middle Name:
Last Name:BRANCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26411 OAK RIDGE DR # 3
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1964
Mailing Address - Country:US
Mailing Address - Phone:936-337-0607
Mailing Address - Fax:
Practice Address - Street 1:26411 OAK RIDGE DR # 3
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1964
Practice Address - Country:US
Practice Address - Phone:936-337-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX528641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical