Provider Demographics
NPI:1063773232
Name:PLACZEK, TALIA
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:PLACZEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 BRENTWOOD DR
Mailing Address - Street 2:#1
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3377
Mailing Address - Country:US
Mailing Address - Phone:402-331-3232
Mailing Address - Fax:
Practice Address - Street 1:8610 BRENTWOOD DR
Practice Address - Street 2:#1
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3377
Practice Address - Country:US
Practice Address - Phone:402-331-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health