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NPI Code Detail

MEDICARE: TAYLOR LEIGH CLINE

MEDICARE: TAYLOR LEIGH CLINE
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 CounselorFL

General Provider Information

NPI Number : 1952957623
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LEIGH CLINE
Provider Business Mailing Address
First Line : 3380 BALSAM DR
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-2014
Country : US
Telephone Number : 941-223-7836
Fax Number :
Provider Business Practice Location Address
First Line : 206 W SYBELIA AVE
Second Line :
City : MAITLAND
State : FL
Zip : 32751-4739
Country : US
Telephone Number : 941-223-7836
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2019
Last Update Date : 04/15/2021

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Directions to “ TAYLOR LEIGH CLINE ” Practice Location

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