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General NPI Number Information
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NPI Number | 1033603568
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Entity Type | Individual
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Provider Name | TAYLOR WEGMANN MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 39 E MAIN ST STE 203
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City | MARLTON
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State | NJ
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Zip | 08053-2154
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Country | US
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Telephone | 856-409-0610
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Fax |
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Provider Business Mailing Address
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Address Line | 426 CHANTICLEER
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City | CHERRY HILL
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State | NJ
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Zip | 08003-4831
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Country | US
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Telephone | 609-922-3803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW021815
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05790900
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License Number State | NJ
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