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General NPI Number Information
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NPI Number | 1265810501
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Entity Type | Individual
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Provider Name | BRYAN TAYLOR LSSP, LPC-S
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Gender | Male
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 606 AVENUE J
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City | MARBLE FALLS
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State | TX
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Zip | 78654-5146
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Country | US
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Telephone | 830-693-0530
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Fax | 830-637-7438
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Provider Business Mailing Address
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Address Line | PO BOX 1731
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City | MARBLE FALLS
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State | TX
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Zip | 78654-7731
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Country | US
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Telephone | 830-693-0530
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Fax | 830-637-7438
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9922
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License Number State | TX
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