| Doctor Name: | COLLENE TAYLOR |
| NPI Number: | 1306118120 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.P.C. |
| License Number: | 180-008117 |
| Business Practice Address: | 475 Southtowne Dr Belvidere, IL - 610085643 |
| Business Phone Number: | 8155444849 |
| Business Fax Number: | 8155442116 |
| Mailing Address: | 1021 N Mulford Rd, ROCKFORD |
| State: | IL |
| Postal Code: | 611073877 |
| Phone Number: | 8153875600 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2012 |
| NPI Last Update Date: | 02/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180-008117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |