=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578538344
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA L. TALAMANTE-POHLMANN MC, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3303 E BASELINE RD SUITE 113
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234-2738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-326-8344
-----------------------------------------------------
Fax | 480-821-0843
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 62 E ELGIN ST
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85296-6412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-326-8344
-----------------------------------------------------
Fax | 480-821-0843
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC 2324
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------