Individual
TALIA TOBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
1276 APEX LN, CHARLESTON, SC 29412-8639
(843) 243-7026
Mailing address
1276 APEX LN, CHARLESTON, SC 29412-8639
(843) 243-7026
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
14505
SC
1041C0700X
Clinical Social Worker
Primary
16780
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
08/02/2022
Last updated
05/08/2024
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