Provider Demographics
NPI:1841768512
Name:JEFFREY, TALITHA MYLIA
Entity Type:Individual
Prefix:MRS
First Name:TALITHA
Middle Name:MYLIA
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TALITHA
Other - Middle Name:
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1335 HERRINGTON RD APT 3322
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6431
Mailing Address - Country:US
Mailing Address - Phone:404-583-1154
Mailing Address - Fax:
Practice Address - Street 1:1335 HERRINGTON RD APT 3322
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-6431
Practice Address - Country:US
Practice Address - Phone:404-583-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist