Provider Demographics
NPI:1831656552
Name:TALLEY, GILES HOWELL
Entity Type:Individual
Prefix:
First Name:GILES
Middle Name:HOWELL
Last Name:TALLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 ABILENE DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-6609
Mailing Address - Country:US
Mailing Address - Phone:730-436-1892
Mailing Address - Fax:
Practice Address - Street 1:707 STARKEY CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7229
Practice Address - Country:US
Practice Address - Phone:720-849-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst