Healthcare Provider Details

I. General information

NPI: 1306769401
Provider Name (Legal Business Name): MARIAH TALIFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26026 TELEGRAPH RD STE 200-1023
SOUTHFIELD MI
48033-2560
US

IV. Provider business mailing address

13952 ROSEMONT AVE
DETROIT MI
48223-3552
US

V. Phone/Fax

Practice location:
  • Phone: 947-900-8545
  • Fax:
Mailing address:
  • Phone: 313-414-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: