Healthcare Provider Details

I. General information

NPI: 1265598064
Provider Name (Legal Business Name): T.A.L.K.SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 05/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9310 SUN CITY BLVD SUITE 105
LAS VEGAS NV
89134-1705
US

IV. Provider business mailing address

9310 SUN CITY BLVD SUITE 105
LAS VEGAS NV
89134-1705
US

V. Phone/Fax

Practice location:
  • Phone: 702-341-8352
  • Fax: 702-341-8365
Mailing address:
  • Phone: 702-341-8352
  • Fax: 702-341-8365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-163
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-170
License Number StateNV

VIII. Authorized Official

Name: PAMELA M HANSON
Title or Position: PRESIDENT
Credential: MST
Phone: 702-341-8352