Most Relevant Information
Provider Data
| NPI Number: | 1003075623 |
| Provider Name: | JOHN STANLEY TALLEY LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 4008 |
Most Important Dates
| Enumeration Date: | 06/09/2008 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
420 AVENUE F
BOGALUSA
LA
704273600
Practice Location Phone/Fax
| Phone: | 9857320058 |
| Fax: | 9857320019 |
Provider Mailing Location
5959 S SHERWOOD FOREST BLVD
BATON ROUGE
LA
708166038
Provider Mailing Phone/Fax
| Phone: | 2255260001 |
| Fax: | 2257659196 |