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General NPI Number Information
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NPI Number | 1184633224
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Entity Type | Individual
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Provider Name | NICOLE ALYASSA TAYLOR MS
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 99 NW 183RD ST
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City | MIAMI
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State | FL
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Zip | 33169-4502
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Country | US
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Telephone | 305-652-2874
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Fax | 305-652-8528
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Provider Business Mailing Address
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Address Line | 1250 SW 27TH AVE SUITE 402
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City | MIAMI
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State | FL
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Zip | 33135-4741
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Country | US
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Telephone | 305-398-6100
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Fax | 305-757-4465
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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 | MH 8216
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License Number State | FL
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