Healthcare Provider Details

I. General information

NPI: 1972313906
Provider Name (Legal Business Name): JAMIELLA MONET TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 HILL AVE LOT 218
TOLEDO OH
43607-4721
US

IV. Provider business mailing address

636 WAVERLY AVE
TOLEDO OH
43607-3836
US

V. Phone/Fax

Practice location:
  • Phone: 567-315-2386
  • Fax:
Mailing address:
  • Phone: 419-705-9168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
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: