Provider Demographics
NPI:1356910590
Name:SOWALSKY, TALIA LONN
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:LONN
Last Name:SOWALSKY
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 1:22303 CHATSFORD CIRCUIT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-6241
Mailing Address - Country:US
Mailing Address - Phone:917-715-9797
Mailing Address - Fax:
Practice Address - Street 1:10 W SQUARE LAKE RD STE 102
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0466
Practice Address - Country:US
Practice Address - Phone:313-355-0008
Practice Address - Fax:248-569-3704
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist