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General NPI Number Information
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NPI Number | 1598985533
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Entity Type | Individual
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Provider Name | DEBRA LYNN TAYLOR CACIII, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 11/10/2013
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Provider Practice Location Address
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Address Line | 107 W 11TH ST
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City | DELTA
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State | CO
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Zip | 81416-1811
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Country | US
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Telephone | 970-399-2927
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 CRITERION ST
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City | DELTA
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State | CO
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Zip | 81416-7701
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Country | US
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Telephone | 970-874-5692
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2674
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3590
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License Number State | CO
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