Healthcare Provider Details

I. General information

NPI: 1093531063
Provider Name (Legal Business Name): TALANDA WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 CHAPMAN RD
NEWARK DE
19702-5499
US

IV. Provider business mailing address

21 TETHER CT
WILMINGTON DE
19808-2742
US

V. Phone/Fax

Practice location:
  • Phone: 302-292-1334
  • Fax:
Mailing address:
  • Phone: 302-981-2334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: