Individual
HEATHER TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5650 N GREEN BAY AVE STE 205, GLENDALE, WI 53209-4446
(262) 999-3495
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(262) 999-3495
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15733-132
WI
101YP2500X
Professional Counselor
Primary
5426-125
WI
Other
Enumeration date
11/21/2011
Last updated
06/02/2025
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