Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1316039159 |
---|---|
Provider Name | Linda Taliaferro |
First Address | W. Bloomfield, MI 48322 |
Second Address | W. Bloomfield, MI 48322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |