Provider Demographics
NPI:1285419721
Name:POSSELT, TALAYA MARIE
Entity type:Individual
Prefix:
First Name:TALAYA
Middle Name:MARIE
Last Name:POSSELT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TALAYA
Other - Middle Name:MARIE
Other - Last Name:SCHAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:240 W CHOCTAW AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-6634
Mailing Address - Country:US
Mailing Address - Phone:208-512-3159
Mailing Address - Fax:
Practice Address - Street 1:8680 N WAYNE DR STE A
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-5037
Practice Address - Country:US
Practice Address - Phone:208-635-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician