Provider Demographics
NPI:1952786014
Name:HITT, TALLI
Entity Type:Individual
Prefix:DR
First Name:TALLI
Middle Name:
Last Name:HITT
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 1:1115 ELKTON DR STE 301
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3884
Mailing Address - Country:US
Mailing Address - Phone:193-576-4717
Mailing Address - Fax:
Practice Address - Street 1:1115 ELKTON DR STE 301
Practice Address - Street 2:
Practice Address - City:COLORADO SPGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3884
Practice Address - Country:US
Practice Address - Phone:719-357-6471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X
CO0005031103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent