Individual
TALIA WAITKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW BCBA
Contact information
Practice address
4236 OLD LEEDS LN, MOUNTAIN BRK, AL 35213-3314
(407) 227-7845
Mailing address
4236 OLD LEEDS LN, MOUNTAIN BRK, AL 35213-3314
(407) 227-7845
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
SW23067
FL
1041C0700X
Clinical Social Worker
Primary
6192C
AL
Other
Enumeration date
07/25/2016
Last updated
07/14/2025
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