Provider Demographics
NPI:1679356455
Name:TALBERT, ANASTASIA LAPRE (CMHS)
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:LAPRE
Last Name:TALBERT
Suffix:
Gender:F
Credentials:CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5385 MAHONING AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1169
Mailing Address - Country:US
Mailing Address - Phone:330-565-0017
Mailing Address - Fax:
Practice Address - Street 1:5385 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1169
Practice Address - Country:US
Practice Address - Phone:330-565-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNA163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management