Healthcare Provider Details

I. General information

NPI: 1659704575
Provider Name (Legal Business Name): JOANE MARY TAGLIAMONTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 S STATE ST
OSCODA MI
48750-1642
US

IV. Provider business mailing address

1035 W WASHINGTON AVE
ALPENA MI
49707-2929
US

V. Phone/Fax

Practice location:
  • Phone: 989-739-2550
  • Fax:
Mailing address:
  • Phone: 989-736-9815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401013918
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: