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General NPI Number Information
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NPI Number | 1437891546
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Entity Type | Individual
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Provider Name | JONAH TAYLOR LSW
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Gender | Male
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Dates
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Enumeration Date | 04/09/2022
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Last Update Date | 05/22/2022
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Provider Practice Location Address
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Address Line | 233 S 6TH ST STE C33
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3763
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Country | US
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Telephone | 484-589-0927
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Fax |
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Provider Business Mailing Address
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Address Line | 134 AVONDALE AVE
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2636
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Country | US
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Telephone | 609-634-2472
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06788200
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License Number State | NJ
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