Healthcare Provider Details

I. General information

NPI: 1558943969
Provider Name (Legal Business Name): MRS. TAYLOR ELIZABETH PACE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2021
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 E MAIN ST
LANCASTER OH
43130-3903
US

IV. Provider business mailing address

4440 RAMSDELL DR
COLUMBUS OH
43231-6167
US

V. Phone/Fax

Practice location:
  • Phone: 740-417-9265
  • Fax:
Mailing address:
  • Phone: 330-605-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: