Healthcare Provider Details

I. General information

NPI: 1508422866
Provider Name (Legal Business Name): MS. ROSEANNE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 10/14/2026
Certification Date: 10/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 FATHER DEVALLES BLVD STE 15
FALL RIVER MA
02723-1519
US

IV. Provider business mailing address

127 W. RODNEY FRENCH BLVD. S2104C-5
NEW BEDFORD MA
02744
US

V. Phone/Fax

Practice location:
  • Phone: 774-400-6522
  • Fax:
Mailing address:
  • Phone: 401-218-0744
  • Fax: 877-892-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number127127
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: