Healthcare Provider Details

I. General information

NPI: 1225583479
Provider Name (Legal Business Name): ALI NOEL TALENTI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 TECH BLVD
TAMPA FL
33619-7865
US

IV. Provider business mailing address

1410 TECH BLVD
TAMPA FL
33619-7865
US

V. Phone/Fax

Practice location:
  • Phone: 813-635-9765
  • Fax: 813-635-9725
Mailing address:
  • Phone: 813-635-9765
  • Fax: 813-635-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: