Provider Demographics
NPI:1407674047
Name:PALMER, TELAJAH (RBT)
Entity type:Individual
Prefix:
First Name:TELAJAH
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12246 QUEENSTON BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5355
Mailing Address - Country:US
Mailing Address - Phone:281-899-0146
Mailing Address - Fax:346-299-9049
Practice Address - Street 1:12246 QUEENSTON BLVD STE G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5355
Practice Address - Country:US
Practice Address - Phone:281-899-0146
Practice Address - Fax:346-299-9049
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-24-376623106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty