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NPI Code Detail

MEDICARE: MCKENZIE TAYLOR PADDOCK

MEDICARE: MCKENZIE TAYLOR PADDOCK
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1427666957
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENZIE TAYLOR PADDOCK
Provider Business Mailing Address
First Line : 16 BRADFORD ST # 2
Second Line :
City : QUINCY
State : MA
Zip : 02169-7820
Country : US
Telephone Number : 203-482-6263
Fax Number :
Provider Business Practice Location Address
First Line : 1501 WASHINGTON ST
Second Line :
City : BRAINTREE
State : MA
Zip : 02184-7599
Country : US
Telephone Number : 617-769-7202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2020
Last Update Date : 07/21/2020

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Directions to “ MCKENZIE TAYLOR PADDOCK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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