Individual
MR. CHARLES W. TALCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA/LSAC
Contact information
Practice address
VA MEDICAL CTR, 500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
VA MEDICAL CTR, 500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
369794-6006
UT
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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