Healthcare Provider Details

I. General information

NPI: 1982112447
Provider Name (Legal Business Name): TAYLOUR KIDD LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 MASSILLON RD STE 206
AKRON OH
44312-5983
US

IV. Provider business mailing address

3333 MASSILLON RD STE 206
AKRON OH
44312-5983
US

V. Phone/Fax

Practice location:
  • Phone: 330-563-4222
  • Fax: 234-274-8293
Mailing address:
  • Phone: 330-563-4222
  • Fax: 234-274-8293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: