Healthcare Provider Details

I. General information

NPI: 1134056096
Provider Name (Legal Business Name): TALORA WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9712 BELAIR RD STE 202
NOTTINGHAM MD
21236-1112
US

IV. Provider business mailing address

9712 BELAIR RD STE 202
NOTTINGHAM MD
21236-1112
US

V. Phone/Fax

Practice location:
  • Phone: 443-473-3098
  • Fax: 855-940-0212
Mailing address:
  • Phone: 443-473-3098
  • Fax: 855-940-0212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NESER TALO
Title or Position: OWNER
Credential: CNRP
Phone: 443-864-0881