Healthcare Provider Details

I. General information

NPI: 1497667885
Provider Name (Legal Business Name): TAYLOR EARLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 WAUKEGAN ST
AUBURN HILLS MI
48326-3264
US

IV. Provider business mailing address

40752 WINDEMERE DR
CLINTON TOWNSHIP MI
48038-3792
US

V. Phone/Fax

Practice location:
  • Phone: 248-537-6900
  • Fax:
Mailing address:
  • Phone: 586-295-7733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801122862
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: