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General NPI Number Information
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NPI Number | 1366948382
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Entity Type | Individual
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Provider Name | JAY CHRISTOPHER TAYLOR
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Gender | Male
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 63 CHERRY ST STE 2
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City | MILFORD
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State | CT
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Zip | 06460-3490
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Country | US
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Telephone | 203-283-9358
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Fax |
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Provider Business Mailing Address
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Address Line | 63 CHERRY ST STE 2
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City | MILFORD
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State | CT
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Zip | 06460-3490
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Country | US
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Telephone | 203-283-9358
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Fax | 203-283-9358
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3117
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License Number State | CT
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