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General NPI Number Information
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NPI Number | 1649803925
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Entity Type | Individual
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Provider Name | JESSIE LEIGH TAYLOR LICDC, MFT
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Gender | Female
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Dates
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Enumeration Date | 02/15/2020
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 6202 TRUST DR
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City | HOLLAND
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State | OH
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Zip | 43528-8425
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Country | US
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Telephone | 406-214-7532
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Fax |
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Provider Business Mailing Address
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Address Line | 550 WINTHROP ST
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City | TOLEDO
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State | OH
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Zip | 43620-1116
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M.2500350
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.162055
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License Number State | OH
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