Provider Demographics
NPI:1982837357
Name:MAZOR, TALYA (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:TALYA
Middle Name:
Last Name:MAZOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 COLONY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7909
Mailing Address - Country:US
Mailing Address - Phone:919-794-4141
Mailing Address - Fax:336-450-2672
Practice Address - Street 1:510 COLONY WOODS DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7909
Practice Address - Country:US
Practice Address - Phone:919-794-4141
Practice Address - Fax:336-450-2672
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0072951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical