MEDICARE: STACEY ROCHELLE TAYLOR

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
1	225C00000X	Rehabilitation Counselor	225C00000X	NV

General Provider Information

NPI Number	:	1467240572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY ROCHELLE TAYLOR

Provider Business Mailing Address
First Line	:	3204 VILLA PISANI CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-7267
Country	:	US
Telephone Number	:	214-283-0024
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 VILLA PISANI CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-7267
Country	:	US
Telephone Number	:	214-283-0024
Fax Number	:	214-283-0024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	04/28/2025

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