Provider Demographics
NPI:1679941686
Name:CUFF, TALAIA NICOLE EMMA
Entity type:Individual
Prefix:
First Name:TALAIA
Middle Name:NICOLE EMMA
Last Name:CUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TALAIA
Other - Middle Name:NICOLE EMMA
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:212 MEGHAN KAY CV
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1469
Mailing Address - Country:US
Mailing Address - Phone:912-322-1184
Mailing Address - Fax:
Practice Address - Street 1:372 MCLAWS CIR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5636
Practice Address - Country:US
Practice Address - Phone:757-645-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
VA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist