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General NPI Number Information
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NPI Number | 1609744077
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Entity Type | Individual
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Provider Name | TAYLAR CHRISTIOPHER
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Gender | Female
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1845 LINE AVE STE A
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City | SHREVEPORT
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State | LA
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Zip | 71101-4611
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Country | US
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Telephone | 318-402-2354
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Fax |
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Provider Business Mailing Address
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Address Line | 6415 THISTLE LN
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City | KEITHVILLE
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State | LA
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Zip | 71047-8954
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Country | US
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Telephone | 318-402-2354
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 011907925
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License Number State | LA
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