Doctor Name: | MRS. WANDA TAYLOR |
NPI Number: | 1215071758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2116 |
Business Practice Address: | 18311 Wisconsin Street Robertsdale, AL - 36567 |
Business Phone Number: | 2519476260 |
Business Fax Number: | 2519475451 |
Mailing Address: | 18311 Wisconsin Street, ROBERTSDALE |
State: | AL |
Postal Code: | 36567 |
Phone Number: | 2519476260 |
Fax Number: | 2519475451 |
NPI Enumeration Date: | 02/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |