| Doctor Name: | MS. CHARLENE LOGAN TAYLOR |
| NPI Number: | 1518255090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 2898 |
| Business Practice Address: | 820 Jordan St Suite 485 Shreveport, LA - 711014518 |
| Business Phone Number: | 3184245001 |
| Business Fax Number: | 3184245007 |
| Mailing Address: | 820 Jordan St, Suite 485 SHREVEPORT |
| State: | LA |
| Postal Code: | 711014518 |
| Phone Number: | 3184245001 |
| Fax Number: | 3184245007 |
| NPI Enumeration Date: | 07/18/2011 |
| NPI Last Update Date: | 10/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2898 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |