Doctor Name: | ELIZABETH GAMBLE TAYLOR |
NPI Number: | 1083738447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LICSW |
License Number: | 15897 |
Business Practice Address: | 8401 Wayzata Blvd Ste 370 Golden Valley, MN - 554261379 |
Business Phone Number: | 7635441006 |
Business Fax Number: | 7635441008 |
Mailing Address: | 5108 Vincent Ave S, MINNEAPOLIS |
State: | MN |
Postal Code: | 554102249 |
Phone Number: | 6128895250 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 15897 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |