Healthcare Provider Details

I. General information

NPI: 1033841978
Provider Name (Legal Business Name): TAYLOR FIELD THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FREEDOM RD
CARSON NM
87517-8047
US

IV. Provider business mailing address

PO BOX 126
CARSON NM
87517-0126
US

V. Phone/Fax

Practice location:
  • Phone: 954-232-4482
  • Fax:
Mailing address:
  • Phone: 954-232-4482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR FIELD
Title or Position: OWNER/PROVIDER
Credential: LMFT
Phone: 954-232-4482