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Individual

MS. MARIE TALLENT DELOACH

Active
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Individual

MS. MARIE TALLENT DELOACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MT(ASCP)

Taxonomy

Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
03671395
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000K3526
NM
01
HSZ196
MEDICARE PART B
NM
Enumeration date
02/06/2012
Last updated
02/06/2012
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