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NPI Code Detail

MEDICARE: MRS. LAURIE MAE TAYLOR MFT

MEDICARE: MRS. LAURIE MAE TAYLOR MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC 41351CA

General Provider Information

NPI Number : 1205968260
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURIE MAE TAYLOR MFT
Provider Business Mailing Address
First Line : PO BOX 2692
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91386-2692
Country : US
Telephone Number : 661-478-9013
Fax Number :
Provider Business Practice Location Address
First Line : 601 S GLENOAKS BLVD STE 200
Second Line :
City : BURBANK
State : CA
Zip : 91502-2787
Country : US
Telephone Number : 818-441-7800
Fax Number : 818-441-0014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 07/08/2007

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