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General NPI Number Information
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NPI Number | 1194403014
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Entity Type | Individual
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Provider Name | LINDA W TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 7324 W CHEYENNE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89129-7427
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Country | US
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Telephone | 248-867-7617
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Fax | 248-281-0648
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Provider Business Mailing Address
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Address Line | 7324 W CHEYENNE AVE STE 7
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City | LAS VEGAS
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State | NV
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Zip | 89129-7426
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Country | US
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Telephone | 248-867-7617
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Fax | 248-281-0468
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PRSS-SUP-5039
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License Number State | NV
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