# CLEMENTINE HOLISTIC HEALING FOR WOMEN '

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316856016
- **Authorized official:** ROBIN D TALLENT PMHNP (OWNER)
- **Authorized official phone:** (415) 902-0366

## Contact information

- **Practice address:** 17505 W CATAWBA AVE STE 130, CORNELIUS, NC 28031-8058
- **Practice address phone:** (415) 902-0366
- **Mailing address:** 17505 W CATAWBA AVE STE 130, CORNELIUS, NC 28031-8058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/07/2026
- **Last updated:** 09/07/2026