Healthcare Provider Details

I. General information

NPI: 1790608172
Provider Name (Legal Business Name): TAYLOR BROOKE HARTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 CHRISTIANA RIVER DR
CLAYTON DE
19938-3925
US

IV. Provider business mailing address

358 CHRISTIANA RIVER DR
CLAYTON DE
19938-3925
US

V. Phone/Fax

Practice location:
  • Phone: 484-402-0495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL8-0011208
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: