Healthcare Provider Details

I. General information

NPI: 1457262909
Provider Name (Legal Business Name): MICHELLE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 CAUGHLIN PKWY STE 200
RENO NV
89519-0972
US

IV. Provider business mailing address

6611 CLAYMONT CT
RENO NV
89523-3214
US

V. Phone/Fax

Practice location:
  • Phone: 320-905-4345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM14811
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: