Provider Demographics
NPI:1366101768
Name:TALBOT CHILD PSYCHOLOGY
Entity type:Organization
Organization Name:TALBOT CHILD PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATURE
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-662-2219
Mailing Address - Street 1:8168 ELLIOTT RD STE 1
Mailing Address - Street 2:#1013
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6547 PEACH BLOSSOM HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4517
Practice Address - Country:US
Practice Address - Phone:667-662-2219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty