Provider Demographics
NPI:1184266215
Name:RUDY ZALTZMAN, TALI (MS, BCBA)
Entity type:Individual
Prefix:
First Name:TALI
Middle Name:
Last Name:RUDY ZALTZMAN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 ADAMS ST.
Mailing Address - Street 2:P.O. BOX 220542
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1626
Mailing Address - Country:US
Mailing Address - Phone:617-794-6699
Mailing Address - Fax:
Practice Address - Street 1:101 LONGWATER CIR STE 101
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1641
Practice Address - Country:US
Practice Address - Phone:845-267-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst