Provider Demographics
NPI:1689793374
Name:TORIBIO REYES, TALETHA MICHELLE (MA)
Entity Type:Individual
Prefix:MS
First Name:TALETHA
Middle Name:MICHELLE
Last Name:TORIBIO REYES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 S TRYON ST STE F188
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7652
Mailing Address - Country:US
Mailing Address - Phone:704-412-8232
Mailing Address - Fax:
Practice Address - Street 1:13000 S TRYON ST STE F188
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7652
Practice Address - Country:US
Practice Address - Phone:704-412-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health