Provider Demographics
NPI:1851141477
Name:TALBOT, TANJA
Entity Type:Individual
Prefix:
First Name:TANJA
Middle Name:
Last Name:TALBOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1932
Mailing Address - Country:US
Mailing Address - Phone:413-768-8286
Mailing Address - Fax:413-773-0239
Practice Address - Street 1:296 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1932
Practice Address - Country:US
Practice Address - Phone:413-768-8286
Practice Address - Fax:413-773-0239
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health