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General NPI Number Information
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NPI Number | 1548832389
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Entity Type | Individual
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Provider Name | KRISTEN TAYLOR LPC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 888 W BIG BEAVER RD
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City | TROY
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State | MI
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Zip | 48084-4736
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Country | US
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Telephone | 313-266-0372
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Fax |
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Provider Business Mailing Address
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Address Line | 319 S MARSHALL ST
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City | PONTIAC
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State | MI
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Zip | 48342-3248
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Country | US
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Telephone | 313-266-0372
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401018947
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License Number State | MI
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