Organization
ANTHONY M TALLEY SR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY M TALLEY SR. (OWNER)
(317) 590-4572
Entity
Organization
Contact information
Practice address
8760 POWDERHORN WAY, INDIANAPOLIS, IN 46256-1178
(317) 590-4572
(866) 598-3720
Mailing address
8760 POWDERHORN WAY, INDIANAPOLIS, IN 46256-1178
(317) 590-4572
(866) 598-3720
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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