Healthcare Provider Details

I. General information

NPI: 1548195324
Provider Name (Legal Business Name): KATHERINE TAYLOR
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 HARBOR WAY APT 147
ANN ARBOR MI
48103-6932
US

IV. Provider business mailing address

275 HARBOR WAY APT 147
ANN ARBOR MI
48103-6932
US

V. Phone/Fax

Practice location:
  • Phone: 585-747-2410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121949
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: