Individual
TALIAH HALEEMA ALICOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
651 SOUTH AVE, PISCATAWAY, NJ 08854-1460
(908) 943-1787
Mailing address
651 SOUTH AVE, PISCATAWAY, NJ 08854-1460
(908) 943-1787
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NJ
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02041984
—
NJ
Enumeration date
01/14/2021
Last updated
01/14/2021
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