Healthcare Provider Details

I. General information

NPI: 1598685356
Provider Name (Legal Business Name): MS. TAYLOR NALANI MACON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6171 CITRUS BLVD STE D BOX 136
HARAHAN LA
70123
US

IV. Provider business mailing address

6171 CITRUS BLVD STE D BOX 136
HARAHAN LA
70123
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: