Provider Demographics
NPI:1942529078
Name:TALLEY, RAYMOND PAUL (BSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:PAUL
Last Name:TALLEY
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3813
Mailing Address - Country:US
Mailing Address - Phone:405-425-0390
Mailing Address - Fax:405-425-0312
Practice Address - Street 1:2709 BRIARCLIFF RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-3813
Practice Address - Country:US
Practice Address - Phone:405-425-0390
Practice Address - Fax:405-425-0312
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker