Blount, Talisa

Blount, Talisa is an individual health care provider with primary practice located at 1301 W Providence Ave , Orange CA 92868-3808. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Assistive Technology Practitioner. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Blount, Talisa can be contacted via phone (714) 639-4990.

Contact Information

Primary practice address
1301 W Providence Ave Orange CA 92868-3808
Phone: (714) 639-4990
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AU2153 California
Speech, Language and Hearing Service Providers / Assistive Technology Practitioner 231HA2400X HA4112 California

Profile Details

NPI number 1487632980
LBN Legal business name Blount, Talisa
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487632980 NPPES
California MEDICAID AU0021530

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