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General NPI Number Information
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NPI Number | 1053441915
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Entity Type | Individual
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Provider Name | MIRIAM ANNETTE TAYLOR LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 4925 PACKARD ST
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City | ANN ARBOR
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State | MI
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Zip | 48108-1521
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Country | US
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Telephone | 734-971-9781
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Fax |
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Provider Business Mailing Address
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Address Line | 1193 CABOT DR
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City | FLINT
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State | MI
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Zip | 48532-2635
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Country | US
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Telephone | 810-760-2675
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Fax | 810-760-2094
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6801087536
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License Number State | MI
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