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Individual

MICHAEL TALLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1417 PARTIN DR N, STE. ONE, NICEVILLE, FL 32578-1430
(850) 729-0303
(850) 729-0305
Mailing address
1417 PARTIN DR N, STE. ONE, NICEVILLE, FL 32578-1430
(850) 729-0303
(850) 729-0305

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4031
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17604047878
NPI
FL
Enumeration date
07/12/2006
Last updated
10/20/2011
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