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Individual

AMY M TALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
770 WOODLANE RD # 80603804, WESTAMPTON, NJ 08060-3804
(609) 267-5928
Mailing address
220 W BRANCH AVE APT 312, PINE HILL, NJ 08021-7036
(856) 842-2227

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
T02970407453952
LICENSE
NJ
Enumeration date
08/01/2024
Last updated
08/01/2024
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