Provider Demographics
NPI:1780019091
Name:TAFLINSKI, LEIDA G
Entity Type:Individual
Prefix:MRS
First Name:LEIDA
Middle Name:G
Last Name:TAFLINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LEIDA
Other - Middle Name:G
Other - Last Name:TAFLINSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:63 ISABELLA AVE
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4365
Mailing Address - Country:US
Mailing Address - Phone:201-779-7073
Mailing Address - Fax:
Practice Address - Street 1:63 ISABELLA AVE
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4365
Practice Address - Country:US
Practice Address - Phone:201-779-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00473300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional