Provider Demographics
NPI:1932456894
Name:TALLO, ANGELA LORIN (M ED, NCC, LPCS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LORIN
Last Name:TALLO
Suffix:
Gender:F
Credentials:M ED, NCC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 FROSTWOOD DR
Mailing Address - Street 2:SUITE 670
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2314
Mailing Address - Country:US
Mailing Address - Phone:281-917-1667
Mailing Address - Fax:
Practice Address - Street 1:920 FROSTWOOD DR
Practice Address - Street 2:SUITE 670
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2314
Practice Address - Country:US
Practice Address - Phone:281-917-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional