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General NPI Number Information
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NPI Number | 1205389046
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Entity Type | Organization
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Legal Business Name | TAYLOR STEWART LLC
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 495 E MOUND ST STE 110
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City | COLUMBUS
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State | OH
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Zip | 43215-5596
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Country | US
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Telephone | 614-264-4165
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Fax | 614-368-0651
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Provider Business Mailing Address
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Address Line | 968 CARPENTER ST
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City | COLUMBUS
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State | OH
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Zip | 43206-2482
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Country | US
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Telephone | 614-264-4165
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAYLOR STEWART
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Credential |
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Telephone | 614-264-4165
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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 | I1501279
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License Number State | OH
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