| Doctor Name: | JAIME WARD TAYLOR |
| NPI Number: | 1235285297 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | QP, BS |
| License Number: | 3409081 |
| Business Practice Address: | 62 Ida Brown Lane Lillington, NC - 27546 |
| Business Phone Number: | 9108140044 |
| Business Fax Number: | 9108933474 |
| Mailing Address: | 1128 Paddington Pl, FAYETTEVILLE |
| State: | NC |
| Postal Code: | 283146304 |
| Phone Number: | 9106705625 |
| Fax Number: | 9108933474 |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 3409081 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |