MEDICARE: TALQ LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6770-C	NV

General Provider Information

NPI Number	:	1346623808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALQ LTD

Provider Business Mailing Address
First Line	:	6867 W CHARLESTON BLVD STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1669
Country	:	US
Telephone Number	:	702-266-6160
Fax Number	:

Provider Business Practice Location Address
First Line	:	6867 W CHARLESTON BLVD STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1669
Country	:	US
Telephone Number	:	702-266-6160
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. EUGENE GONZALES RUIZ
Credential	:
Telephone Number	:	702-266-6160

Provider Enumeration Date	:	07/02/2015
Last Update Date	:	07/02/2015

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