Provider Demographics
NPI:1700118056
Name:TALBOT, TALONA (LMFT)
Entity Type:Individual
Prefix:
First Name:TALONA
Middle Name:
Last Name:TALBOT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 36TH ST # 270
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2050
Mailing Address - Country:US
Mailing Address - Phone:801-393-6232
Mailing Address - Fax:
Practice Address - Street 1:1140 36TH ST # 270
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2050
Practice Address - Country:US
Practice Address - Phone:801-393-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5571105-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT5571105-3902OtherUTAH DEPARTMENT OF OCCUPATIONAL AND PROFESSIONAL LICENSING